{ "hospital_name": "Riverview Regional Medical Center", "last_updated_on": "2025-12-09","version": "2.2.0", "hospital_location": ["Riverview Regional Medical Center"],"hospital_address": [ "600 South Third Street Gadsden, AL 35901" ], "license_information": { "license_number": "472228529", "state": "AL" }, "affirmation": { "affirmation": "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.", "confirm_affirmation": true } , "standard_charge_information": [ { "description": "Hc Pfizer-Biontech Covid-19 Vaccine Administration – First Dose", "code_information": [ { "code": "0001A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Pfizer-Biontech Covid-19 Vaccine Administration – Second Dose", "code_information": [ { "code": "0002A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" }]}]} , { "description": "Vaccine administration", "code_information": [ { "code": "0003A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" }]}]} , { "description": "Liver dis 10 assays wnash", "code_information": [ { "code": "0003M", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2517, "discounted_cash": 654,"minimum": 97,"maximum": 2517,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2265.3, "standard_charge_percentage": 90.0000, "estimated_amount": 2265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1778.26, "standard_charge_percentage": 78.5000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 478.23, "estimated_amount": 478, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1916.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1916.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1877.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1510.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1916.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2202.38, "standard_charge_percentage": 87.5000, "estimated_amount": 2202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1258.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1258, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 97, "estimated_amount": 97, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 352.38, "estimated_amount": 352, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2391.15, "standard_charge_percentage": 95.0000, "estimated_amount": 2391, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 578.91, "estimated_amount": 578, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1877.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1916.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1384.35, "standard_charge_percentage": 55.0000, "estimated_amount": 1384, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1258.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 508.43, "estimated_amount": 508, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 704.76, "estimated_amount": 704, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 996.73, "standard_charge_percentage": 39.6000, "estimated_amount": 996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1887.75, "standard_charge_percentage": 75.0000, "estimated_amount": 1887, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2265.3, "standard_charge_percentage": 90.0000, "estimated_amount": 2265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2139.45, "standard_charge_percentage": 85.0000, "estimated_amount": 2139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 755.1, "standard_charge_percentage": 30.0000, "estimated_amount": 755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 498.37, "estimated_amount": 498, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1117.55, "standard_charge_percentage": 44.4000, "estimated_amount": 1117, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1916.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1916, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1258.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 780.27, "estimated_amount": 780, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 352.38, "estimated_amount": 352, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2466.66, "standard_charge_percentage": 98.0000, "estimated_amount": 2466, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2517, "standard_charge_percentage": 100.0000, "estimated_amount": 2517, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1817.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 513.47, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 515.36, "estimated_amount": 515, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2391.15, "standard_charge_percentage": 95.0000, "estimated_amount": 2391, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1975.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1975, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1956.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1975.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1975, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2265.3, "standard_charge_percentage": 90.0000, "estimated_amount": 2265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 780.27, "estimated_amount": 780, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2139.45, "standard_charge_percentage": 85.0000, "estimated_amount": 2139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1975.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1975, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2013.6, "standard_charge_percentage": 80.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Pfizer-Biontech Covid-19 Vaccine Administration – Booster Dose", "code_information": [ { "code": "0004A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Moderna Covid-19 Vaccine Administration – First Dose", "code_information": [ { "code": "0011A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Moderna Covid-19 Vaccine Administration – Second Dose", "code_information": [ { "code": "0012A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Moderna Covid-19 Vaccine Administration – Third Dose", "code_information": [ { "code": "0013A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00160", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6119.54,"minimum": 30.5,"maximum": 6119.54,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4563.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5813.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4755.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4755, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5201.61, "standard_charge_percentage": 85.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3671.72, "standard_charge_percentage": 60.0000, "estimated_amount": 3671, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6119.54, "standard_charge_percentage": 100.0000, "estimated_amount": 6119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5201.61, "standard_charge_percentage": 85.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4563.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1835.86, "standard_charge_percentage": 30.0000, "estimated_amount": 1835, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5813.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5354.6, "standard_charge_percentage": 87.5000, "estimated_amount": 5354, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5997.15, "standard_charge_percentage": 98.0000, "estimated_amount": 5997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2717.08, "standard_charge_percentage": 44.4000, "estimated_amount": 2717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4323.46, "standard_charge_percentage": 78.5000, "estimated_amount": 4323, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3365.75, "standard_charge_percentage": 55.0000, "estimated_amount": 3365, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2423.34, "standard_charge_percentage": 39.6000, "estimated_amount": 2423, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4419.53, "standard_charge_percentage": 78.5000, "estimated_amount": 4419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4589.65, "standard_charge_percentage": 75.0000, "estimated_amount": 4589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Astrazeneca Covid-19 Vaccine Administration – First Dose", "code_information": [ { "code": "0021A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Astrazeneca Covid-19 Vaccine Administration – Second Dose", "code_information": [ { "code": "0022A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Imm Admn Sarscov2 Ad26 5X1010 Vp/0.5 Ml 1 Dose", "code_information": [ { "code": "0031A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Johnson&Johnson Covid-19 Vaccine Administration - Booster Dose", "code_information": [ { "code": "0034A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00400", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4483.49,"minimum": 30.5,"maximum": 4483.49,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1775.46, "standard_charge_percentage": 39.6000, "estimated_amount": 1775, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4035.14, "standard_charge_percentage": 90.0000, "estimated_amount": 4035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4035.14, "standard_charge_percentage": 90.0000, "estimated_amount": 4035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3413.95, "standard_charge_percentage": 78.5000, "estimated_amount": 3413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3923.05, "standard_charge_percentage": 87.5000, "estimated_amount": 3923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1345.05, "standard_charge_percentage": 30.0000, "estimated_amount": 1345, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3237.98, "standard_charge_percentage": 78.5000, "estimated_amount": 3237, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1990.67, "standard_charge_percentage": 44.4000, "estimated_amount": 1990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3343.56, "standard_charge_percentage": 78.5000, "estimated_amount": 3343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3484.34, "standard_charge_percentage": 78.5000, "estimated_amount": 3484, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4259.32, "standard_charge_percentage": 95.0000, "estimated_amount": 4259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3810.97, "standard_charge_percentage": 85.0000, "estimated_amount": 3810, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4035.14, "standard_charge_percentage": 90.0000, "estimated_amount": 4035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3519.54, "standard_charge_percentage": 78.5000, "estimated_amount": 3519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2690.09, "standard_charge_percentage": 60.0000, "estimated_amount": 2690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3519.54, "standard_charge_percentage": 78.5000, "estimated_amount": 3519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3413.95, "standard_charge_percentage": 78.5000, "estimated_amount": 3413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4259.32, "standard_charge_percentage": 95.0000, "estimated_amount": 4259, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2241.74, "standard_charge_percentage": 50.0000, "estimated_amount": 2241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2465.92, "standard_charge_percentage": 55.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3810.97, "standard_charge_percentage": 85.0000, "estimated_amount": 3810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3413.95, "standard_charge_percentage": 78.5000, "estimated_amount": 3413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3413.95, "standard_charge_percentage": 78.5000, "estimated_amount": 3413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3167.59, "standard_charge_percentage": 78.5000, "estimated_amount": 3167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4483.49, "standard_charge_percentage": 100.0000, "estimated_amount": 4483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3362.62, "standard_charge_percentage": 75.0000, "estimated_amount": 3362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2241.74, "standard_charge_percentage": 50.0000, "estimated_amount": 2241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2241.74, "standard_charge_percentage": 50.0000, "estimated_amount": 2241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3519.54, "standard_charge_percentage": 78.5000, "estimated_amount": 3519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4393.82, "standard_charge_percentage": 98.0000, "estimated_amount": 4393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3586.79, "standard_charge_percentage": 80.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3413.95, "standard_charge_percentage": 78.5000, "estimated_amount": 3413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3343.56, "standard_charge_percentage": 78.5000, "estimated_amount": 3343, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" }]}]} , { "description": "Hc Cerbral Perfusion Study, Ct W/ Contrast", "code_information": [ { "code": "0042T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2538.97,"minimum": 363,"maximum": 2538.97,"payers_information":[{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1793.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1993.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1993, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1005.43, "standard_charge_percentage": 39.6000, "estimated_amount": 1005, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2221.6, "standard_charge_percentage": 87.5000, "estimated_amount": 2221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1893.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1893, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1269.48, "standard_charge_percentage": 50.0000, "estimated_amount": 1269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1973.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 761.69, "standard_charge_percentage": 30.0000, "estimated_amount": 761, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2158.12, "standard_charge_percentage": 85.0000, "estimated_amount": 2158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1396.43, "standard_charge_percentage": 55.0000, "estimated_amount": 1396, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1933.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1933, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1933.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1933, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1933.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1933, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1269.48, "standard_charge_percentage": 50.0000, "estimated_amount": 1269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2285.07, "standard_charge_percentage": 90.0000, "estimated_amount": 2285, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1933.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1933, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1523.38, "standard_charge_percentage": 60.0000, "estimated_amount": 1523, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1993.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1893.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2412.02, "standard_charge_percentage": 95.0000, "estimated_amount": 2412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1933.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1933, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2488.19, "standard_charge_percentage": 98.0000, "estimated_amount": 2488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2158.12, "standard_charge_percentage": 85.0000, "estimated_amount": 2158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1904.23, "standard_charge_percentage": 75.0000, "estimated_amount": 1904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2285.07, "standard_charge_percentage": 90.0000, "estimated_amount": 2285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2538.97, "standard_charge_percentage": 100.0000, "estimated_amount": 2538, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1269.48, "standard_charge_percentage": 50.0000, "estimated_amount": 1269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2285.07, "standard_charge_percentage": 90.0000, "estimated_amount": 2285, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 403.1, "estimated_amount": 403, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2031.18, "standard_charge_percentage": 80.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 363, "estimated_amount": 363, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1833.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1993.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2412.02, "standard_charge_percentage": 95.0000, "estimated_amount": 2412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 954, "estimated_amount": 954, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "0054T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 33546.8,"minimum": 511,"maximum": 33546.8,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 13284.5, "standard_charge_percentage": 39.6000, "estimated_amount": 13284, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 28514.8, "standard_charge_percentage": 85.0000, "estimated_amount": 28514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 26334.3, "standard_charge_percentage": 78.5000, "estimated_amount": 26334, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 32875.9, "standard_charge_percentage": 98.0000, "estimated_amount": 32875, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 16773.4, "standard_charge_percentage": 50.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 28514.8, "standard_charge_percentage": 85.0000, "estimated_amount": 28514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 16773.4, "standard_charge_percentage": 50.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 25544.2, "standard_charge_percentage": 78.5000, "estimated_amount": 25544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 30192.2, "standard_charge_percentage": 90.0000, "estimated_amount": 30192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 25017.6, "standard_charge_percentage": 78.5000, "estimated_amount": 25017, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 29353.5, "standard_charge_percentage": 87.5000, "estimated_amount": 29353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 25160.1, "standard_charge_percentage": 75.0000, "estimated_amount": 25160, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 25544.2, "standard_charge_percentage": 78.5000, "estimated_amount": 25544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 16773.4, "standard_charge_percentage": 50.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 25017.6, "standard_charge_percentage": 78.5000, "estimated_amount": 25017, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 31869.5, "standard_charge_percentage": 95.0000, "estimated_amount": 31869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 30192.2, "standard_charge_percentage": 90.0000, "estimated_amount": 30192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 23700.8, "standard_charge_percentage": 78.5000, "estimated_amount": 23700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 26334.3, "standard_charge_percentage": 78.5000, "estimated_amount": 26334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10064, "standard_charge_percentage": 30.0000, "estimated_amount": 10064, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 25544.2, "standard_charge_percentage": 78.5000, "estimated_amount": 25544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 33546.8, "standard_charge_percentage": 100.0000, "estimated_amount": 33546, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 25544.2, "standard_charge_percentage": 78.5000, "estimated_amount": 25544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 24227.5, "standard_charge_percentage": 78.5000, "estimated_amount": 24227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 26070.9, "standard_charge_percentage": 78.5000, "estimated_amount": 26070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 18450.8, "standard_charge_percentage": 55.0000, "estimated_amount": 18450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 31869.5, "standard_charge_percentage": 95.0000, "estimated_amount": 31869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 30192.2, "standard_charge_percentage": 90.0000, "estimated_amount": 30192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 25544.2, "standard_charge_percentage": 78.5000, "estimated_amount": 25544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 26837.5, "standard_charge_percentage": 80.0000, "estimated_amount": 26837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 26334.3, "standard_charge_percentage": 78.5000, "estimated_amount": 26334, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "0055T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 36234.1,"minimum": 511,"maximum": 36234.1,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 34422.4, "standard_charge_percentage": 95.0000, "estimated_amount": 34422, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 35509.5, "standard_charge_percentage": 98.0000, "estimated_amount": 35509, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 27590.5, "standard_charge_percentage": 78.5000, "estimated_amount": 27590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 27021.6, "standard_charge_percentage": 78.5000, "estimated_amount": 27021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 19928.8, "standard_charge_percentage": 55.0000, "estimated_amount": 19928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 28159.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 36234.1, "standard_charge_percentage": 100.0000, "estimated_amount": 36234, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28443.8, "standard_charge_percentage": 78.5000, "estimated_amount": 28443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 18117.1, "standard_charge_percentage": 50.0000, "estimated_amount": 18117, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 32610.7, "standard_charge_percentage": 90.0000, "estimated_amount": 32610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 27175.6, "standard_charge_percentage": 75.0000, "estimated_amount": 27175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 25599.4, "standard_charge_percentage": 78.5000, "estimated_amount": 25599, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 30799, "standard_charge_percentage": 85.0000, "estimated_amount": 30799, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 18117.1, "standard_charge_percentage": 50.0000, "estimated_amount": 18117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 27590.5, "standard_charge_percentage": 78.5000, "estimated_amount": 27590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 31704.9, "standard_charge_percentage": 87.5000, "estimated_amount": 31704, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 26168.3, "standard_charge_percentage": 78.5000, "estimated_amount": 26168, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 18117.1, "standard_charge_percentage": 50.0000, "estimated_amount": 18117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 34422.4, "standard_charge_percentage": 95.0000, "estimated_amount": 34422, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 27590.5, "standard_charge_percentage": 78.5000, "estimated_amount": 27590, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 27590.5, "standard_charge_percentage": 78.5000, "estimated_amount": 27590, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 32610.7, "standard_charge_percentage": 90.0000, "estimated_amount": 32610, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 14348.7, "standard_charge_percentage": 39.6000, "estimated_amount": 14348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 27590.5, "standard_charge_percentage": 78.5000, "estimated_amount": 27590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10870.2, "standard_charge_percentage": 30.0000, "estimated_amount": 10870, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 28443.8, "standard_charge_percentage": 78.5000, "estimated_amount": 28443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 30799, "standard_charge_percentage": 85.0000, "estimated_amount": 30799, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 28443.8, "standard_charge_percentage": 78.5000, "estimated_amount": 28443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 27021.6, "standard_charge_percentage": 78.5000, "estimated_amount": 27021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28987.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 32610.7, "standard_charge_percentage": 90.0000, "estimated_amount": 32610, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00630", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2008.96,"minimum": 30.5,"maximum": 2008.96,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1529.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 891.98, "standard_charge_percentage": 44.4000, "estimated_amount": 891, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1707.62, "standard_charge_percentage": 85.0000, "estimated_amount": 1707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1757.84, "standard_charge_percentage": 87.5000, "estimated_amount": 1757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1529.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1529, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1450.87, "standard_charge_percentage": 78.5000, "estimated_amount": 1450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1004.48, "standard_charge_percentage": 50.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 602.69, "standard_charge_percentage": 30.0000, "estimated_amount": 602, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1908.51, "standard_charge_percentage": 95.0000, "estimated_amount": 1908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1498.18, "standard_charge_percentage": 78.5000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1529.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1004.48, "standard_charge_percentage": 50.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1707.62, "standard_charge_percentage": 85.0000, "estimated_amount": 1707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1419.33, "standard_charge_percentage": 78.5000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1104.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1506.72, "standard_charge_percentage": 75.0000, "estimated_amount": 1506, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1498.18, "standard_charge_percentage": 78.5000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1577.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1808.06, "standard_charge_percentage": 90.0000, "estimated_amount": 1808, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 795.55, "standard_charge_percentage": 39.6000, "estimated_amount": 795, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1577.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1205.38, "standard_charge_percentage": 60.0000, "estimated_amount": 1205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1908.51, "standard_charge_percentage": 95.0000, "estimated_amount": 1908, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1968.78, "standard_charge_percentage": 98.0000, "estimated_amount": 1968, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2008.96, "standard_charge_percentage": 100.0000, "estimated_amount": 2008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1561.26, "standard_charge_percentage": 78.5000, "estimated_amount": 1561, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1808.06, "standard_charge_percentage": 90.0000, "estimated_amount": 1808, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1004.48, "standard_charge_percentage": 50.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1808.06, "standard_charge_percentage": 90.0000, "estimated_amount": 1808, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1607.17, "standard_charge_percentage": 80.0000, "estimated_amount": 1607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1577.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1529.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1529.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1529, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Moderna Covid-19 Vaccine Administration – Booster Dose", "code_information": [ { "code": "0064A", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 40,"minimum": 12,"maximum": 40,"payers_information":[{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 30, "standard_charge_percentage": 75.0000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 17.76, "standard_charge_percentage": 44.4000, "estimated_amount": 17, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 24, "standard_charge_percentage": 60.0000, "estimated_amount": 24, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 39.2, "standard_charge_percentage": 98.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 28.26, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 40, "standard_charge_percentage": 100.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22, "standard_charge_percentage": 55.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12, "standard_charge_percentage": 30.0000, "estimated_amount": 12, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 31.09, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28.89, "standard_charge_percentage": 78.5000, "estimated_amount": 28, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 36, "standard_charge_percentage": 90.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20, "standard_charge_percentage": 50.0000, "estimated_amount": 20, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 30.46, "standard_charge_percentage": 78.5000, "estimated_amount": 30, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 31.4, "standard_charge_percentage": 78.5000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 38, "standard_charge_percentage": 95.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29.83, "standard_charge_percentage": 78.5000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 34, "standard_charge_percentage": 85.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 35, "standard_charge_percentage": 87.5000, "estimated_amount": 35, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 32, "standard_charge_percentage": 80.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15.84, "standard_charge_percentage": 39.6000, "estimated_amount": 15, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00731", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1165.56,"minimum": 30.5,"maximum": 1165.56,"payers_information":[{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 990.73, "standard_charge_percentage": 85.0000, "estimated_amount": 990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 990.73, "standard_charge_percentage": 85.0000, "estimated_amount": 990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 699.34, "standard_charge_percentage": 60.0000, "estimated_amount": 699, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 905.81, "standard_charge_percentage": 78.5000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 641.06, "standard_charge_percentage": 55.0000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 841.77, "standard_charge_percentage": 78.5000, "estimated_amount": 841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 349.67, "standard_charge_percentage": 30.0000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1107.28, "standard_charge_percentage": 95.0000, "estimated_amount": 1107, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 461.56, "standard_charge_percentage": 39.6000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1142.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 869.22, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1165.56, "standard_charge_percentage": 100.0000, "estimated_amount": 1165, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 517.51, "standard_charge_percentage": 44.4000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 823.47, "standard_charge_percentage": 78.5000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1019.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1107.28, "standard_charge_percentage": 95.0000, "estimated_amount": 1107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 874.17, "standard_charge_percentage": 75.0000, "estimated_amount": 874, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 869.22, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00732", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6119.54,"minimum": 30.5,"maximum": 6119.54,"payers_information":[{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5201.61, "standard_charge_percentage": 85.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4563.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2423.34, "standard_charge_percentage": 39.6000, "estimated_amount": 2423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4755.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2717.08, "standard_charge_percentage": 44.4000, "estimated_amount": 2717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3365.75, "standard_charge_percentage": 55.0000, "estimated_amount": 3365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4323.46, "standard_charge_percentage": 78.5000, "estimated_amount": 4323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4589.65, "standard_charge_percentage": 75.0000, "estimated_amount": 4589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4419.53, "standard_charge_percentage": 78.5000, "estimated_amount": 4419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1835.86, "standard_charge_percentage": 30.0000, "estimated_amount": 1835, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4563.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6119.54, "standard_charge_percentage": 100.0000, "estimated_amount": 6119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5813.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5813.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3671.72, "standard_charge_percentage": 60.0000, "estimated_amount": 3671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5354.6, "standard_charge_percentage": 87.5000, "estimated_amount": 5354, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5201.61, "standard_charge_percentage": 85.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5997.15, "standard_charge_percentage": 98.0000, "estimated_amount": 5997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00790", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3665.46,"minimum": 30.5,"maximum": 3665.46,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2877.39, "standard_charge_percentage": 78.5000, "estimated_amount": 2877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3298.91, "standard_charge_percentage": 90.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1627.46, "standard_charge_percentage": 44.4000, "estimated_amount": 1627, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1451.52, "standard_charge_percentage": 39.6000, "estimated_amount": 1451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2016, "standard_charge_percentage": 55.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2199.28, "standard_charge_percentage": 60.0000, "estimated_amount": 2199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3665.46, "standard_charge_percentage": 100.0000, "estimated_amount": 3665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1832.73, "standard_charge_percentage": 50.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2733.52, "standard_charge_percentage": 78.5000, "estimated_amount": 2733, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2877.39, "standard_charge_percentage": 78.5000, "estimated_amount": 2877, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1832.73, "standard_charge_percentage": 50.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2848.61, "standard_charge_percentage": 78.5000, "estimated_amount": 2848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1099.64, "standard_charge_percentage": 30.0000, "estimated_amount": 1099, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2733.52, "standard_charge_percentage": 78.5000, "estimated_amount": 2733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3207.28, "standard_charge_percentage": 87.5000, "estimated_amount": 3207, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2749.09, "standard_charge_percentage": 75.0000, "estimated_amount": 2749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2877.39, "standard_charge_percentage": 78.5000, "estimated_amount": 2877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3298.91, "standard_charge_percentage": 90.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3115.64, "standard_charge_percentage": 85.0000, "estimated_amount": 3115, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1832.73, "standard_charge_percentage": 50.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3482.19, "standard_charge_percentage": 95.0000, "estimated_amount": 3482, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2589.65, "standard_charge_percentage": 78.5000, "estimated_amount": 2589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3298.91, "standard_charge_percentage": 90.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3592.15, "standard_charge_percentage": 98.0000, "estimated_amount": 3592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3115.64, "standard_charge_percentage": 85.0000, "estimated_amount": 3115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3482.19, "standard_charge_percentage": 95.0000, "estimated_amount": 3482, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2647.2, "standard_charge_percentage": 78.5000, "estimated_amount": 2647, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00811", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1165.56,"minimum": 30.5,"maximum": 1165.56,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 874.17, "standard_charge_percentage": 75.0000, "estimated_amount": 874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 517.51, "standard_charge_percentage": 44.4000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 641.06, "standard_charge_percentage": 55.0000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 349.67, "standard_charge_percentage": 30.0000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 990.73, "standard_charge_percentage": 85.0000, "estimated_amount": 990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 869.22, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 699.34, "standard_charge_percentage": 60.0000, "estimated_amount": 699, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 823.47, "standard_charge_percentage": 78.5000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 869.22, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1107.28, "standard_charge_percentage": 95.0000, "estimated_amount": 1107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1107.28, "standard_charge_percentage": 95.0000, "estimated_amount": 1107, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1142.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1142, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1165.56, "standard_charge_percentage": 100.0000, "estimated_amount": 1165, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1019.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 841.77, "standard_charge_percentage": 78.5000, "estimated_amount": 841, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 461.56, "standard_charge_percentage": 39.6000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 990.73, "standard_charge_percentage": 85.0000, "estimated_amount": 990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 905.81, "standard_charge_percentage": 78.5000, "estimated_amount": 905, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00812", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1165.56,"minimum": 30.5,"maximum": 1165.56,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 905.81, "standard_charge_percentage": 78.5000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 869.22, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 823.47, "standard_charge_percentage": 78.5000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1165.56, "standard_charge_percentage": 100.0000, "estimated_amount": 1165, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1107.28, "standard_charge_percentage": 95.0000, "estimated_amount": 1107, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1107.28, "standard_charge_percentage": 95.0000, "estimated_amount": 1107, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 874.17, "standard_charge_percentage": 75.0000, "estimated_amount": 874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 461.56, "standard_charge_percentage": 39.6000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 990.73, "standard_charge_percentage": 85.0000, "estimated_amount": 990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 869.22, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 699.34, "standard_charge_percentage": 60.0000, "estimated_amount": 699, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 582.78, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1142.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 517.51, "standard_charge_percentage": 44.4000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 841.77, "standard_charge_percentage": 78.5000, "estimated_amount": 841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1019.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 990.73, "standard_charge_percentage": 85.0000, "estimated_amount": 990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 932.45, "standard_charge_percentage": 80.0000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 887.52, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1049, "standard_charge_percentage": 90.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 349.67, "standard_charge_percentage": 30.0000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 914.96, "standard_charge_percentage": 78.5000, "estimated_amount": 914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 641.06, "standard_charge_percentage": 55.0000, "estimated_amount": 641, "methodology": "percent of total billed charges" }]}]} , { "description": "Anesthesia", "code_information": [ { "code": "00813", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1125.21,"minimum": 30.5,"maximum": 1125.21,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 562.61, "standard_charge_percentage": 50.0000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 337.56, "standard_charge_percentage": 30.0000, "estimated_amount": 337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1068.95, "standard_charge_percentage": 95.0000, "estimated_amount": 1068, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 856.79, "standard_charge_percentage": 78.5000, "estimated_amount": 856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 883.29, "standard_charge_percentage": 78.5000, "estimated_amount": 883, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1012.69, "standard_charge_percentage": 90.0000, "estimated_amount": 1012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1125.21, "standard_charge_percentage": 100.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 956.43, "standard_charge_percentage": 85.0000, "estimated_amount": 956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 794.96, "standard_charge_percentage": 78.5000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 956.43, "standard_charge_percentage": 85.0000, "estimated_amount": 956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 499.59, "standard_charge_percentage": 44.4000, "estimated_amount": 499, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 856.79, "standard_charge_percentage": 78.5000, "estimated_amount": 856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 984.56, "standard_charge_percentage": 87.5000, "estimated_amount": 984, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 562.61, "standard_charge_percentage": 50.0000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 675.13, "standard_charge_percentage": 60.0000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1102.71, "standard_charge_percentage": 98.0000, "estimated_amount": 1102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 856.79, "standard_charge_percentage": 78.5000, "estimated_amount": 856, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 812.63, "standard_charge_percentage": 78.5000, "estimated_amount": 812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 843.91, "standard_charge_percentage": 75.0000, "estimated_amount": 843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 618.87, "standard_charge_percentage": 55.0000, "estimated_amount": 618, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 856.79, "standard_charge_percentage": 78.5000, "estimated_amount": 856, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 883.29, "standard_charge_percentage": 78.5000, "estimated_amount": 883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 874.46, "standard_charge_percentage": 78.5000, "estimated_amount": 874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 883.29, "standard_charge_percentage": 78.5000, "estimated_amount": 883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1012.69, "standard_charge_percentage": 90.0000, "estimated_amount": 1012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1068.95, "standard_charge_percentage": 95.0000, "estimated_amount": 1068, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 839.13, "standard_charge_percentage": 78.5000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1012.69, "standard_charge_percentage": 90.0000, "estimated_amount": 1012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 839.13, "standard_charge_percentage": 78.5000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 900.17, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 562.61, "standard_charge_percentage": 50.0000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 856.79, "standard_charge_percentage": 78.5000, "estimated_amount": 856, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 445.58, "standard_charge_percentage": 39.6000, "estimated_amount": 445, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00832", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2847.43,"minimum": 30.5,"maximum": 2847.43,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2235.23, "standard_charge_percentage": 78.5000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1566.09, "standard_charge_percentage": 55.0000, "estimated_amount": 1566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2562.69, "standard_charge_percentage": 90.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 854.23, "standard_charge_percentage": 30.0000, "estimated_amount": 854, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2705.06, "standard_charge_percentage": 95.0000, "estimated_amount": 2705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2123.47, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2011.71, "standard_charge_percentage": 78.5000, "estimated_amount": 2011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1423.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2562.69, "standard_charge_percentage": 90.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1127.58, "standard_charge_percentage": 39.6000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2212.88, "standard_charge_percentage": 78.5000, "estimated_amount": 2212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1264.26, "standard_charge_percentage": 44.4000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1423.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2420.32, "standard_charge_percentage": 85.0000, "estimated_amount": 2420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2235.23, "standard_charge_percentage": 78.5000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2135.57, "standard_charge_percentage": 75.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2847.43, "standard_charge_percentage": 100.0000, "estimated_amount": 2847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2705.06, "standard_charge_percentage": 95.0000, "estimated_amount": 2705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2123.47, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1708.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1423.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2562.69, "standard_charge_percentage": 90.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2056.41, "standard_charge_percentage": 78.5000, "estimated_amount": 2056, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2790.48, "standard_charge_percentage": 98.0000, "estimated_amount": 2790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2235.23, "standard_charge_percentage": 78.5000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2420.32, "standard_charge_percentage": 85.0000, "estimated_amount": 2420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2491.5, "standard_charge_percentage": 87.5000, "estimated_amount": 2491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "00902", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6119.54,"minimum": 30.5,"maximum": 6119.54,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4755.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2423.34, "standard_charge_percentage": 39.6000, "estimated_amount": 2423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3365.75, "standard_charge_percentage": 55.0000, "estimated_amount": 3365, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5813.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4589.65, "standard_charge_percentage": 75.0000, "estimated_amount": 4589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5997.15, "standard_charge_percentage": 98.0000, "estimated_amount": 5997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6119.54, "standard_charge_percentage": 100.0000, "estimated_amount": 6119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4563.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2717.08, "standard_charge_percentage": 44.4000, "estimated_amount": 2717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4419.53, "standard_charge_percentage": 78.5000, "estimated_amount": 4419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5354.6, "standard_charge_percentage": 87.5000, "estimated_amount": 5354, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3671.72, "standard_charge_percentage": 60.0000, "estimated_amount": 3671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4323.46, "standard_charge_percentage": 78.5000, "estimated_amount": 4323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4563.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4563, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5813.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5201.61, "standard_charge_percentage": 85.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5201.61, "standard_charge_percentage": 85.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1835.86, "standard_charge_percentage": 30.0000, "estimated_amount": 1835, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01214", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2029.41,"minimum": 30.5,"maximum": 2029.41,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1014.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 901.06, "standard_charge_percentage": 44.4000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1433.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1433, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 803.65, "standard_charge_percentage": 39.6000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1217.65, "standard_charge_percentage": 60.0000, "estimated_amount": 1217, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1465.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1465, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 608.82, "standard_charge_percentage": 30.0000, "estimated_amount": 608, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1014.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1014.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1593.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1725, "standard_charge_percentage": 85.0000, "estimated_amount": 1725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1513.43, "standard_charge_percentage": 78.5000, "estimated_amount": 1513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2029.41, "standard_charge_percentage": 100.0000, "estimated_amount": 2029, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1577.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1577, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1988.82, "standard_charge_percentage": 98.0000, "estimated_amount": 1988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1593.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1775.73, "standard_charge_percentage": 87.5000, "estimated_amount": 1775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1116.18, "standard_charge_percentage": 55.0000, "estimated_amount": 1116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1826.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1513.43, "standard_charge_percentage": 78.5000, "estimated_amount": 1513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1927.94, "standard_charge_percentage": 95.0000, "estimated_amount": 1927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1927.94, "standard_charge_percentage": 95.0000, "estimated_amount": 1927, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1826.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1593.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1522.06, "standard_charge_percentage": 75.0000, "estimated_amount": 1522, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1826.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1725, "standard_charge_percentage": 85.0000, "estimated_amount": 1725, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01400", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3838.41,"minimum": 30.5,"maximum": 3838.41,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3454.57, "standard_charge_percentage": 90.0000, "estimated_amount": 3454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2862.49, "standard_charge_percentage": 78.5000, "estimated_amount": 2862, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2772.1, "standard_charge_percentage": 78.5000, "estimated_amount": 2772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1520.01, "standard_charge_percentage": 39.6000, "estimated_amount": 1520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3013.15, "standard_charge_percentage": 78.5000, "estimated_amount": 3013, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3262.65, "standard_charge_percentage": 85.0000, "estimated_amount": 3262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2111.13, "standard_charge_percentage": 55.0000, "estimated_amount": 2111, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2922.76, "standard_charge_percentage": 78.5000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2303.05, "standard_charge_percentage": 60.0000, "estimated_amount": 2303, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3761.64, "standard_charge_percentage": 98.0000, "estimated_amount": 3761, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3262.65, "standard_charge_percentage": 85.0000, "estimated_amount": 3262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3646.49, "standard_charge_percentage": 95.0000, "estimated_amount": 3646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1919.2, "standard_charge_percentage": 50.0000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3454.57, "standard_charge_percentage": 90.0000, "estimated_amount": 3454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2922.76, "standard_charge_percentage": 78.5000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1919.2, "standard_charge_percentage": 50.0000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1704.25, "standard_charge_percentage": 44.4000, "estimated_amount": 1704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2862.49, "standard_charge_percentage": 78.5000, "estimated_amount": 2862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2922.76, "standard_charge_percentage": 78.5000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3646.49, "standard_charge_percentage": 95.0000, "estimated_amount": 3646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2922.76, "standard_charge_percentage": 78.5000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2878.81, "standard_charge_percentage": 75.0000, "estimated_amount": 2878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2711.84, "standard_charge_percentage": 78.5000, "estimated_amount": 2711, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3454.57, "standard_charge_percentage": 90.0000, "estimated_amount": 3454, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2922.76, "standard_charge_percentage": 78.5000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1151.52, "standard_charge_percentage": 30.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1919.2, "standard_charge_percentage": 50.0000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3838.41, "standard_charge_percentage": 100.0000, "estimated_amount": 3838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3013.15, "standard_charge_percentage": 78.5000, "estimated_amount": 3013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3013.15, "standard_charge_percentage": 78.5000, "estimated_amount": 3013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3358.61, "standard_charge_percentage": 87.5000, "estimated_amount": 3358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2983.02, "standard_charge_percentage": 78.5000, "estimated_amount": 2983, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3070.73, "standard_charge_percentage": 80.0000, "estimated_amount": 3070, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01402", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1989.97,"minimum": 30.5,"maximum": 1989.97,"payers_information":[{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1094.48, "standard_charge_percentage": 55.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 883.55, "standard_charge_percentage": 44.4000, "estimated_amount": 883, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1790.97, "standard_charge_percentage": 90.0000, "estimated_amount": 1790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1515.26, "standard_charge_percentage": 78.5000, "estimated_amount": 1515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1691.47, "standard_charge_percentage": 85.0000, "estimated_amount": 1691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1405.91, "standard_charge_percentage": 78.5000, "estimated_amount": 1405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 596.99, "standard_charge_percentage": 30.0000, "estimated_amount": 596, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 788.03, "standard_charge_percentage": 39.6000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 994.99, "standard_charge_percentage": 50.0000, "estimated_amount": 994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1515.26, "standard_charge_percentage": 78.5000, "estimated_amount": 1515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1193.98, "standard_charge_percentage": 60.0000, "estimated_amount": 1193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1741.22, "standard_charge_percentage": 87.5000, "estimated_amount": 1741, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1790.97, "standard_charge_percentage": 90.0000, "estimated_amount": 1790, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1437.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1562.13, "standard_charge_percentage": 78.5000, "estimated_amount": 1562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1890.47, "standard_charge_percentage": 95.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1492.48, "standard_charge_percentage": 75.0000, "estimated_amount": 1492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1562.13, "standard_charge_percentage": 78.5000, "estimated_amount": 1562, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1691.47, "standard_charge_percentage": 85.0000, "estimated_amount": 1691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1562.13, "standard_charge_percentage": 78.5000, "estimated_amount": 1562, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1546.51, "standard_charge_percentage": 78.5000, "estimated_amount": 1546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1484.02, "standard_charge_percentage": 78.5000, "estimated_amount": 1484, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1950.17, "standard_charge_percentage": 98.0000, "estimated_amount": 1950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1790.97, "standard_charge_percentage": 90.0000, "estimated_amount": 1790, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1591.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1989.97, "standard_charge_percentage": 100.0000, "estimated_amount": 1989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1890.47, "standard_charge_percentage": 95.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 994.99, "standard_charge_percentage": 50.0000, "estimated_amount": 994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1515.26, "standard_charge_percentage": 78.5000, "estimated_amount": 1515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1515.26, "standard_charge_percentage": 78.5000, "estimated_amount": 1515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 994.99, "standard_charge_percentage": 50.0000, "estimated_amount": 994, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1515.26, "standard_charge_percentage": 78.5000, "estimated_amount": 1515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1484.02, "standard_charge_percentage": 78.5000, "estimated_amount": 1484, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01470", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2029.41,"minimum": 30.5,"maximum": 2029.41,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1116.18, "standard_charge_percentage": 55.0000, "estimated_amount": 1116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1826.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1593.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1522.06, "standard_charge_percentage": 75.0000, "estimated_amount": 1522, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 608.82, "standard_charge_percentage": 30.0000, "estimated_amount": 608, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1513.43, "standard_charge_percentage": 78.5000, "estimated_amount": 1513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1014.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1014.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1988.82, "standard_charge_percentage": 98.0000, "estimated_amount": 1988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1577.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 901.06, "standard_charge_percentage": 44.4000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1826.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1593.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1513.43, "standard_charge_percentage": 78.5000, "estimated_amount": 1513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1826.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1217.65, "standard_charge_percentage": 60.0000, "estimated_amount": 1217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1593.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1927.94, "standard_charge_percentage": 95.0000, "estimated_amount": 1927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1433.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2029.41, "standard_charge_percentage": 100.0000, "estimated_amount": 2029, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1725, "standard_charge_percentage": 85.0000, "estimated_amount": 1725, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1545.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 803.65, "standard_charge_percentage": 39.6000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1725, "standard_charge_percentage": 85.0000, "estimated_amount": 1725, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1014.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1927.94, "standard_charge_percentage": 95.0000, "estimated_amount": 1927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1775.73, "standard_charge_percentage": 87.5000, "estimated_amount": 1775, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1465.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1465, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1623.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01480", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2467.87,"minimum": 30.5,"maximum": 2467.87,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2344.48, "standard_charge_percentage": 95.0000, "estimated_amount": 2344, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 977.28, "standard_charge_percentage": 39.6000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1233.93, "standard_charge_percentage": 50.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1937.28, "standard_charge_percentage": 78.5000, "estimated_amount": 1937, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1937.28, "standard_charge_percentage": 78.5000, "estimated_amount": 1937, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1782.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1782, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2097.69, "standard_charge_percentage": 85.0000, "estimated_amount": 2097, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2097.69, "standard_charge_percentage": 85.0000, "estimated_amount": 2097, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1879.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2221.08, "standard_charge_percentage": 90.0000, "estimated_amount": 2221, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2467.87, "standard_charge_percentage": 100.0000, "estimated_amount": 2467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2159.39, "standard_charge_percentage": 87.5000, "estimated_amount": 2159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1743.55, "standard_charge_percentage": 78.5000, "estimated_amount": 1743, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1937.28, "standard_charge_percentage": 78.5000, "estimated_amount": 1937, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1879.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2418.51, "standard_charge_percentage": 98.0000, "estimated_amount": 2418, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2344.48, "standard_charge_percentage": 95.0000, "estimated_amount": 2344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1357.33, "standard_charge_percentage": 55.0000, "estimated_amount": 1357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1840.41, "standard_charge_percentage": 78.5000, "estimated_amount": 1840, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1879.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1850.9, "standard_charge_percentage": 75.0000, "estimated_amount": 1850, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1974.3, "standard_charge_percentage": 80.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1233.93, "standard_charge_percentage": 50.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1879.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1917.91, "standard_charge_percentage": 78.5000, "estimated_amount": 1917, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1480.72, "standard_charge_percentage": 60.0000, "estimated_amount": 1480, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1840.41, "standard_charge_percentage": 78.5000, "estimated_amount": 1840, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1233.93, "standard_charge_percentage": 50.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1095.73, "standard_charge_percentage": 44.4000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2221.08, "standard_charge_percentage": 90.0000, "estimated_amount": 2221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 740.36, "standard_charge_percentage": 30.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2221.08, "standard_charge_percentage": 90.0000, "estimated_amount": 2221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1879.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01630", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2193.01,"minimum": 30.5,"maximum": 2193.01,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2149.15, "standard_charge_percentage": 98.0000, "estimated_amount": 2149, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1721.51, "standard_charge_percentage": 78.5000, "estimated_amount": 1721, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1583.79, "standard_charge_percentage": 78.5000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1315.81, "standard_charge_percentage": 60.0000, "estimated_amount": 1315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1635.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1918.88, "standard_charge_percentage": 87.5000, "estimated_amount": 1918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1206.16, "standard_charge_percentage": 55.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1864.06, "standard_charge_percentage": 85.0000, "estimated_amount": 1864, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1973.71, "standard_charge_percentage": 90.0000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2083.36, "standard_charge_percentage": 95.0000, "estimated_amount": 2083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1973.71, "standard_charge_percentage": 90.0000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1096.51, "standard_charge_percentage": 50.0000, "estimated_amount": 1096, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 657.9, "standard_charge_percentage": 30.0000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1669.87, "standard_charge_percentage": 78.5000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1704.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1721.51, "standard_charge_percentage": 78.5000, "estimated_amount": 1721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1549.36, "standard_charge_percentage": 78.5000, "estimated_amount": 1549, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1973.71, "standard_charge_percentage": 90.0000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1669.87, "standard_charge_percentage": 78.5000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2083.36, "standard_charge_percentage": 95.0000, "estimated_amount": 2083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1864.06, "standard_charge_percentage": 85.0000, "estimated_amount": 1864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1721.51, "standard_charge_percentage": 78.5000, "estimated_amount": 1721, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1096.51, "standard_charge_percentage": 50.0000, "estimated_amount": 1096, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1096.51, "standard_charge_percentage": 50.0000, "estimated_amount": 1096, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 973.7, "standard_charge_percentage": 44.4000, "estimated_amount": 973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1644.76, "standard_charge_percentage": 75.0000, "estimated_amount": 1644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1669.87, "standard_charge_percentage": 78.5000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1669.87, "standard_charge_percentage": 78.5000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1635.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1635, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 868.43, "standard_charge_percentage": 39.6000, "estimated_amount": 868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1669.87, "standard_charge_percentage": 78.5000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2193.01, "standard_charge_percentage": 100.0000, "estimated_amount": 2193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1754.41, "standard_charge_percentage": 80.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01638", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1211.38,"minimum": 30.5,"maximum": 1211.38,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 903.39, "standard_charge_percentage": 78.5000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 537.85, "standard_charge_percentage": 44.4000, "estimated_amount": 537, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 950.93, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1150.81, "standard_charge_percentage": 95.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1059.96, "standard_charge_percentage": 87.5000, "estimated_amount": 1059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1150.81, "standard_charge_percentage": 95.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 855.84, "standard_charge_percentage": 78.5000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 922.41, "standard_charge_percentage": 78.5000, "estimated_amount": 922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 922.41, "standard_charge_percentage": 78.5000, "estimated_amount": 922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1029.67, "standard_charge_percentage": 85.0000, "estimated_amount": 1029, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 726.83, "standard_charge_percentage": 60.0000, "estimated_amount": 726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 666.26, "standard_charge_percentage": 55.0000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 903.39, "standard_charge_percentage": 78.5000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1029.67, "standard_charge_percentage": 85.0000, "estimated_amount": 1029, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 605.69, "standard_charge_percentage": 50.0000, "estimated_amount": 605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 908.54, "standard_charge_percentage": 75.0000, "estimated_amount": 908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1211.38, "standard_charge_percentage": 100.0000, "estimated_amount": 1211, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 479.71, "standard_charge_percentage": 39.6000, "estimated_amount": 479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 922.41, "standard_charge_percentage": 78.5000, "estimated_amount": 922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 605.69, "standard_charge_percentage": 50.0000, "estimated_amount": 605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 922.41, "standard_charge_percentage": 78.5000, "estimated_amount": 922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1090.24, "standard_charge_percentage": 90.0000, "estimated_amount": 1090, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 950.93, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1090.24, "standard_charge_percentage": 90.0000, "estimated_amount": 1090, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 941.42, "standard_charge_percentage": 78.5000, "estimated_amount": 941, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1187.15, "standard_charge_percentage": 98.0000, "estimated_amount": 1187, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 605.69, "standard_charge_percentage": 50.0000, "estimated_amount": 605, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 922.41, "standard_charge_percentage": 78.5000, "estimated_amount": 922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 363.41, "standard_charge_percentage": 30.0000, "estimated_amount": 363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1090.24, "standard_charge_percentage": 90.0000, "estimated_amount": 1090, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 969.1, "standard_charge_percentage": 80.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 874.86, "standard_charge_percentage": 78.5000, "estimated_amount": 874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 950.93, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01710", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3665.46,"minimum": 30.5,"maximum": 3665.46,"payers_information":[{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3115.64, "standard_charge_percentage": 85.0000, "estimated_amount": 3115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3207.28, "standard_charge_percentage": 87.5000, "estimated_amount": 3207, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2877.39, "standard_charge_percentage": 78.5000, "estimated_amount": 2877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2848.61, "standard_charge_percentage": 78.5000, "estimated_amount": 2848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3592.15, "standard_charge_percentage": 98.0000, "estimated_amount": 3592, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1832.73, "standard_charge_percentage": 50.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2589.65, "standard_charge_percentage": 78.5000, "estimated_amount": 2589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2016, "standard_charge_percentage": 55.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2647.2, "standard_charge_percentage": 78.5000, "estimated_amount": 2647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3665.46, "standard_charge_percentage": 100.0000, "estimated_amount": 3665, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1832.73, "standard_charge_percentage": 50.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3298.91, "standard_charge_percentage": 90.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2733.52, "standard_charge_percentage": 78.5000, "estimated_amount": 2733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2749.09, "standard_charge_percentage": 75.0000, "estimated_amount": 2749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3298.91, "standard_charge_percentage": 90.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3482.19, "standard_charge_percentage": 95.0000, "estimated_amount": 3482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2733.52, "standard_charge_percentage": 78.5000, "estimated_amount": 2733, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1832.73, "standard_charge_percentage": 50.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3115.64, "standard_charge_percentage": 85.0000, "estimated_amount": 3115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1451.52, "standard_charge_percentage": 39.6000, "estimated_amount": 1451, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3298.91, "standard_charge_percentage": 90.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2877.39, "standard_charge_percentage": 78.5000, "estimated_amount": 2877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2199.28, "standard_charge_percentage": 60.0000, "estimated_amount": 2199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3482.19, "standard_charge_percentage": 95.0000, "estimated_amount": 3482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2932.37, "standard_charge_percentage": 80.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1627.46, "standard_charge_percentage": 44.4000, "estimated_amount": 1627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2791.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2877.39, "standard_charge_percentage": 78.5000, "estimated_amount": 2877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1099.64, "standard_charge_percentage": 30.0000, "estimated_amount": 1099, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01810", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6119.54,"minimum": 30.5,"maximum": 6119.54,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3671.72, "standard_charge_percentage": 60.0000, "estimated_amount": 3671, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4803.84, "standard_charge_percentage": 78.5000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4563.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4563, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4419.53, "standard_charge_percentage": 78.5000, "estimated_amount": 4419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4755.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2717.08, "standard_charge_percentage": 44.4000, "estimated_amount": 2717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4563.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5354.6, "standard_charge_percentage": 87.5000, "estimated_amount": 5354, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1835.86, "standard_charge_percentage": 30.0000, "estimated_amount": 1835, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5997.15, "standard_charge_percentage": 98.0000, "estimated_amount": 5997, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4589.65, "standard_charge_percentage": 75.0000, "estimated_amount": 4589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3365.75, "standard_charge_percentage": 55.0000, "estimated_amount": 3365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4323.46, "standard_charge_percentage": 78.5000, "estimated_amount": 4323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6119.54, "standard_charge_percentage": 100.0000, "estimated_amount": 6119, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5201.61, "standard_charge_percentage": 85.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3059.77, "standard_charge_percentage": 50.0000, "estimated_amount": 3059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5201.61, "standard_charge_percentage": 85.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5813.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5813.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5813, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2423.34, "standard_charge_percentage": 39.6000, "estimated_amount": 2423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4659.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4895.63, "standard_charge_percentage": 80.0000, "estimated_amount": 4895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5507.59, "standard_charge_percentage": 90.0000, "estimated_amount": 5507, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01830", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2789,"minimum": 30.5,"maximum": 2789,"payers_information":[{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1394.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1394, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2510.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2440.38, "standard_charge_percentage": 87.5000, "estimated_amount": 2440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2123.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2189.36, "standard_charge_percentage": 78.5000, "estimated_amount": 2189, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 836.7, "standard_charge_percentage": 30.0000, "estimated_amount": 836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1394.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1394, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2370.65, "standard_charge_percentage": 85.0000, "estimated_amount": 2370, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1394.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2649.55, "standard_charge_percentage": 95.0000, "estimated_amount": 2649, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2079.9, "standard_charge_percentage": 78.5000, "estimated_amount": 2079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1673.4, "standard_charge_percentage": 60.0000, "estimated_amount": 1673, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2189.36, "standard_charge_percentage": 78.5000, "estimated_amount": 2189, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2079.9, "standard_charge_percentage": 78.5000, "estimated_amount": 2079, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1970.43, "standard_charge_percentage": 78.5000, "estimated_amount": 1970, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2123.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2123.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2789, "standard_charge_percentage": 100.0000, "estimated_amount": 2789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1238.32, "standard_charge_percentage": 44.4000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2189.36, "standard_charge_percentage": 78.5000, "estimated_amount": 2189, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2510.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1104.44, "standard_charge_percentage": 39.6000, "estimated_amount": 1104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2091.75, "standard_charge_percentage": 75.0000, "estimated_amount": 2091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2123.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2014.22, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2231.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1533.95, "standard_charge_percentage": 55.0000, "estimated_amount": 1533, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2167.47, "standard_charge_percentage": 78.5000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2733.22, "standard_charge_percentage": 98.0000, "estimated_amount": 2733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2370.65, "standard_charge_percentage": 85.0000, "estimated_amount": 2370, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2123.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2649.55, "standard_charge_percentage": 95.0000, "estimated_amount": 2649, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2510.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "01942", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2847.43,"minimum": 30.5,"maximum": 2847.43,"payers_information":[{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2011.71, "standard_charge_percentage": 78.5000, "estimated_amount": 2011, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2790.48, "standard_charge_percentage": 98.0000, "estimated_amount": 2790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2135.57, "standard_charge_percentage": 75.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2123.47, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1127.58, "standard_charge_percentage": 39.6000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1423.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2420.32, "standard_charge_percentage": 85.0000, "estimated_amount": 2420, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1423.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2056.41, "standard_charge_percentage": 78.5000, "estimated_amount": 2056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1566.09, "standard_charge_percentage": 55.0000, "estimated_amount": 1566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2235.23, "standard_charge_percentage": 78.5000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2212.88, "standard_charge_percentage": 78.5000, "estimated_amount": 2212, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2235.23, "standard_charge_percentage": 78.5000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1708.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1264.26, "standard_charge_percentage": 44.4000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2235.23, "standard_charge_percentage": 78.5000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 854.23, "standard_charge_percentage": 30.0000, "estimated_amount": 854, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1423.71, "standard_charge_percentage": 50.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2168.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2168, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2562.69, "standard_charge_percentage": 90.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2847.43, "standard_charge_percentage": 100.0000, "estimated_amount": 2847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2491.5, "standard_charge_percentage": 87.5000, "estimated_amount": 2491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2705.06, "standard_charge_percentage": 95.0000, "estimated_amount": 2705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2562.69, "standard_charge_percentage": 90.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2277.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2420.32, "standard_charge_percentage": 85.0000, "estimated_amount": 2420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2705.06, "standard_charge_percentage": 95.0000, "estimated_amount": 2705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2123.47, "standard_charge_percentage": 78.5000, "estimated_amount": 2123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2562.69, "standard_charge_percentage": 90.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Anesth Vag Delivery, Epidural", "code_information": [ { "code": "01967", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1151.33,"minimum": 30.5,"maximum": 1151.33,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1007.41, "standard_charge_percentage": 87.5000, "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 511.19, "standard_charge_percentage": 44.4000, "estimated_amount": 511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 903.79, "standard_charge_percentage": 78.5000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 876.68, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.4, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 633.23, "standard_charge_percentage": 55.0000, "estimated_amount": 633, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 690.8, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1036.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1128.3, "standard_charge_percentage": 98.0000, "estimated_amount": 1128, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 903.79, "standard_charge_percentage": 78.5000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 575.66, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 863.5, "standard_charge_percentage": 75.0000, "estimated_amount": 863, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 831.49, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 978.63, "standard_charge_percentage": 85.0000, "estimated_amount": 978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 575.66, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1036.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 876.68, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 455.93, "standard_charge_percentage": 39.6000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 876.68, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 903.79, "standard_charge_percentage": 78.5000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 858.6, "standard_charge_percentage": 78.5000, "estimated_amount": 858, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 876.68, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 813.41, "standard_charge_percentage": 78.5000, "estimated_amount": 813, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 30.5, "estimated_amount": 30, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 978.63, "standard_charge_percentage": 85.0000, "estimated_amount": 978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1036.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 575.66, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1093.76, "standard_charge_percentage": 95.0000, "estimated_amount": 1093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1151.33, "standard_charge_percentage": 100.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 858.6, "standard_charge_percentage": 78.5000, "estimated_amount": 858, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1093.76, "standard_charge_percentage": 95.0000, "estimated_amount": 1093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 876.68, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 921.06, "standard_charge_percentage": 80.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 894.76, "standard_charge_percentage": 78.5000, "estimated_amount": 894, "methodology": "percent of total billed charges" }]}]} , { "description": "Nfct ds 22 trgt sars-cov-2", "code_information": [ { "code": "0202U", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2136, "discounted_cash": 541,"minimum": 40,"maximum": 2136,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 479.3, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1068, "standard_charge_percentage": 50.0000, "estimated_amount": 1068, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 291.75, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1676.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 291.75, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 151.52, "estimated_amount": 151, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1922.4, "standard_charge_percentage": 90.0000, "estimated_amount": 1922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1626.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1626, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1676.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 646.01, "estimated_amount": 646, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2093.28, "standard_charge_percentage": 98.0000, "estimated_amount": 2093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1626.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1626, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 412.61, "estimated_amount": 412, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2136, "standard_charge_percentage": 100.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 640.8, "standard_charge_percentage": 30.0000, "estimated_amount": 640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1922.4, "standard_charge_percentage": 90.0000, "estimated_amount": 1922, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1922.4, "standard_charge_percentage": 90.0000, "estimated_amount": 1922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1626.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1626, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1281.6, "standard_charge_percentage": 60.0000, "estimated_amount": 1281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1592.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1592, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 420.95, "estimated_amount": 420, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2029.2, "standard_charge_percentage": 95.0000, "estimated_amount": 2029, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 583.49, "estimated_amount": 583, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2029.2, "standard_charge_percentage": 95.0000, "estimated_amount": 2029, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1626.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1626, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1815.6, "standard_charge_percentage": 85.0000, "estimated_amount": 1815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1509.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1509, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1659.99, "standard_charge_percentage": 78.5000, "estimated_amount": 1659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1869, "standard_charge_percentage": 87.5000, "estimated_amount": 1869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1174.8, "standard_charge_percentage": 55.0000, "estimated_amount": 1174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1068, "standard_charge_percentage": 50.0000, "estimated_amount": 1068, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 845.86, "standard_charge_percentage": 39.6000, "estimated_amount": 845, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 395.94, "estimated_amount": 395, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 646.01, "estimated_amount": 646, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 425.12, "estimated_amount": 425, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1708.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1592.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1602, "standard_charge_percentage": 75.0000, "estimated_amount": 1602, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1626.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1626, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1815.6, "standard_charge_percentage": 85.0000, "estimated_amount": 1815, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1542.62, "standard_charge_percentage": 78.5000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 948.38, "standard_charge_percentage": 44.4000, "estimated_amount": 948, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1068, "standard_charge_percentage": 50.0000, "estimated_amount": 1068, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 416.78, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1676.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1676, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "0232T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18643.6, "discounted_cash": 466,"minimum": 340.57,"maximum": 18643.6,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 555.67, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 354.92, "estimated_amount": 354, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16779.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17711.4, "standard_charge_percentage": 95.0000, "estimated_amount": 17711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7382.87, "standard_charge_percentage": 39.6000, "estimated_amount": 7382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9321.81, "standard_charge_percentage": 50.0000, "estimated_amount": 9321, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16779.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16779, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.08, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14196.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13171.7, "standard_charge_percentage": 78.5000, "estimated_amount": 13171, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.57, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13903.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18643.6, "standard_charge_percentage": 100.0000, "estimated_amount": 18643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13903.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5593.09, "standard_charge_percentage": 30.0000, "estimated_amount": 5593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14635.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14635.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14488.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16313.2, "standard_charge_percentage": 87.5000, "estimated_amount": 16313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16779.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 13982.7, "standard_charge_percentage": 75.0000, "estimated_amount": 13982, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 587.17, "estimated_amount": 587, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10254, "standard_charge_percentage": 55.0000, "estimated_amount": 10253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14196.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 501.9, "estimated_amount": 501, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15847.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17711.4, "standard_charge_percentage": 95.0000, "estimated_amount": 17711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14914.9, "standard_charge_percentage": 80.0000, "estimated_amount": 14914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14196.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14635.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14635, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 365.67, "estimated_amount": 365, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9321.81, "standard_charge_percentage": 50.0000, "estimated_amount": 9321, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13464.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14196.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15847.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15847, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9321.81, "standard_charge_percentage": 50.0000, "estimated_amount": 9321, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 555.67, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14196.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14196, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.5, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18270.8, "standard_charge_percentage": 98.0000, "estimated_amount": 18270, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Translum Peripheral Atherectomy Renal Art", "code_information": [ { "code": "0234T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9612.11, "discounted_cash": 13245,"minimum": 2883.63,"maximum": 9612.11,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8650.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7319.14, "standard_charge_percentage": 78.5000, "estimated_amount": 7319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 9523, "estimated_amount": 9523, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7319.14, "standard_charge_percentage": 78.5000, "estimated_amount": 7319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 8170.29, "standard_charge_percentage": 85.0000, "estimated_amount": 8170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 9131.5, "standard_charge_percentage": 95.0000, "estimated_amount": 9131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7319.14, "standard_charge_percentage": 78.5000, "estimated_amount": 7319, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9419.87, "standard_charge_percentage": 98.0000, "estimated_amount": 9419, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4806.06, "standard_charge_percentage": 50.0000, "estimated_amount": 4806, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 8170.29, "standard_charge_percentage": 85.0000, "estimated_amount": 8170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9612.11, "standard_charge_percentage": 100.0000, "estimated_amount": 9612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 9131.5, "standard_charge_percentage": 95.0000, "estimated_amount": 9131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8650.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 7209.08, "standard_charge_percentage": 75.0000, "estimated_amount": 7209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8410.6, "standard_charge_percentage": 87.5000, "estimated_amount": 8410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 7168.23, "standard_charge_percentage": 78.5000, "estimated_amount": 7168, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7470.05, "standard_charge_percentage": 78.5000, "estimated_amount": 7470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 5767.27, "standard_charge_percentage": 60.0000, "estimated_amount": 5767, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4806.06, "standard_charge_percentage": 50.0000, "estimated_amount": 4806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7319.14, "standard_charge_percentage": 78.5000, "estimated_amount": 7319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 6587, "estimated_amount": 6587, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8650.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5286.66, "standard_charge_percentage": 55.0000, "estimated_amount": 5286, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6941.87, "standard_charge_percentage": 78.5000, "estimated_amount": 6941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2883.63, "standard_charge_percentage": 30.0000, "estimated_amount": 2883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6790.96, "standard_charge_percentage": 78.5000, "estimated_amount": 6790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7545.51, "standard_charge_percentage": 78.5000, "estimated_amount": 7545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7545.51, "standard_charge_percentage": 78.5000, "estimated_amount": 7545, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7319.14, "standard_charge_percentage": 78.5000, "estimated_amount": 7319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4806.06, "standard_charge_percentage": 50.0000, "estimated_amount": 4806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7545.51, "standard_charge_percentage": 78.5000, "estimated_amount": 7545, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 9612.11, "estimated_amount": 9612, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3806.4, "standard_charge_percentage": 39.6000, "estimated_amount": 3806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7689.69, "standard_charge_percentage": 80.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 7168.23, "standard_charge_percentage": 78.5000, "estimated_amount": 7168, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Translum Peripheral Atherectomy Visceral Art Ea", "code_information": [ { "code": "0235T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 21322.8,"minimum": 1477,"maximum": 21322.8,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 20256.7, "standard_charge_percentage": 95.0000, "estimated_amount": 20256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10661.4, "standard_charge_percentage": 50.0000, "estimated_amount": 10661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10661.4, "standard_charge_percentage": 50.0000, "estimated_amount": 10661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 20896.3, "standard_charge_percentage": 98.0000, "estimated_amount": 20896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 16571, "standard_charge_percentage": 78.5000, "estimated_amount": 16571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 18124.4, "standard_charge_percentage": 85.0000, "estimated_amount": 18124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 21322.8, "standard_charge_percentage": 100.0000, "estimated_amount": 21322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 19190.5, "standard_charge_percentage": 90.0000, "estimated_amount": 19190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 16738.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 16236.3, "standard_charge_percentage": 78.5000, "estimated_amount": 16236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 15064.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15064, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8443.83, "standard_charge_percentage": 39.6000, "estimated_amount": 8443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 15992.1, "standard_charge_percentage": 75.0000, "estimated_amount": 15992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 12793.7, "standard_charge_percentage": 60.0000, "estimated_amount": 12793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 16236.3, "standard_charge_percentage": 78.5000, "estimated_amount": 16236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6396.84, "standard_charge_percentage": 30.0000, "estimated_amount": 6396, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11727.5, "standard_charge_percentage": 55.0000, "estimated_amount": 11727, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 16738.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16738, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10661.4, "standard_charge_percentage": 50.0000, "estimated_amount": 10661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 19190.5, "standard_charge_percentage": 90.0000, "estimated_amount": 19190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16738.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16738, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 18124.4, "standard_charge_percentage": 85.0000, "estimated_amount": 18124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 19190.5, "standard_charge_percentage": 90.0000, "estimated_amount": 19190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 15901.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 16236.3, "standard_charge_percentage": 78.5000, "estimated_amount": 16236, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 15399.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15399, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 16236.3, "standard_charge_percentage": 78.5000, "estimated_amount": 16236, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 16236.3, "standard_charge_percentage": 78.5000, "estimated_amount": 16236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 9523, "estimated_amount": 9523, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 17058.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 20256.7, "standard_charge_percentage": 95.0000, "estimated_amount": 20256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 18657.5, "standard_charge_percentage": 87.5000, "estimated_amount": 18657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 15901.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15901, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 7518.14, "estimated_amount": 7518, "methodology": "fee schedule" }]}]} , { "description": "Hc Translum Peripheral Atherectomy Abdom Aorta", "code_information": [ { "code": "0236T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 47711.8, "discounted_cash": 13245,"minimum": 6587,"maximum": 47711.8,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 36330.2, "standard_charge_percentage": 78.5000, "estimated_amount": 36330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 41747.8, "standard_charge_percentage": 87.5000, "estimated_amount": 41747, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 37079.2, "standard_charge_percentage": 78.5000, "estimated_amount": 37079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 42940.6, "standard_charge_percentage": 90.0000, "estimated_amount": 42940, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 9679.16, "estimated_amount": 9679, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 36330.2, "standard_charge_percentage": 78.5000, "estimated_amount": 36330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 35581.1, "standard_charge_percentage": 78.5000, "estimated_amount": 35581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 14313.5, "standard_charge_percentage": 30.0000, "estimated_amount": 14313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 35783.8, "standard_charge_percentage": 75.0000, "estimated_amount": 35783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 28627.1, "standard_charge_percentage": 60.0000, "estimated_amount": 28627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 40555, "standard_charge_percentage": 85.0000, "estimated_amount": 40555, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 42940.6, "standard_charge_percentage": 90.0000, "estimated_amount": 42940, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 23855.9, "standard_charge_percentage": 50.0000, "estimated_amount": 23855, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 6587, "estimated_amount": 6587, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 14264, "estimated_amount": 14264, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 10290.5, "estimated_amount": 10290, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 34457.5, "standard_charge_percentage": 78.5000, "estimated_amount": 34457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 20377.2, "estimated_amount": 20377, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 36330.2, "standard_charge_percentage": 78.5000, "estimated_amount": 36330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 36330.2, "standard_charge_percentage": 78.5000, "estimated_amount": 36330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 23855.9, "standard_charge_percentage": 50.0000, "estimated_amount": 23855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 15792.3, "estimated_amount": 15792, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 35581.1, "standard_charge_percentage": 78.5000, "estimated_amount": 35581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 33708.4, "standard_charge_percentage": 78.5000, "estimated_amount": 33708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 10086.7, "estimated_amount": 10086, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 40555, "standard_charge_percentage": 85.0000, "estimated_amount": 40555, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 36330.2, "standard_charge_percentage": 78.5000, "estimated_amount": 36330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 45326.2, "standard_charge_percentage": 95.0000, "estimated_amount": 45326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 15792.3, "estimated_amount": 15792, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 37453.8, "standard_charge_percentage": 78.5000, "estimated_amount": 37453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 13993, "estimated_amount": 13992, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 45326.2, "standard_charge_percentage": 95.0000, "estimated_amount": 45326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 42940.6, "standard_charge_percentage": 90.0000, "estimated_amount": 42940, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 9523, "estimated_amount": 9523, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 37453.8, "standard_charge_percentage": 78.5000, "estimated_amount": 37453, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 46757.6, "standard_charge_percentage": 98.0000, "estimated_amount": 46757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 18893.9, "standard_charge_percentage": 39.6000, "estimated_amount": 18893, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 23855.9, "standard_charge_percentage": 50.0000, "estimated_amount": 23855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 38169.4, "standard_charge_percentage": 80.0000, "estimated_amount": 38169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 10392.4, "estimated_amount": 10392, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 26241.5, "standard_charge_percentage": 55.0000, "estimated_amount": 26241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 37453.8, "standard_charge_percentage": 78.5000, "estimated_amount": 37453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 47711.8, "standard_charge_percentage": 100.0000, "estimated_amount": 47711, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Translum Peripherl Atherectomy Brachiocephal Ea", "code_information": [ { "code": "0237T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38627.1, "discounted_cash": 13245,"minimum": 6587,"maximum": 38627.1,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 29412.6, "standard_charge_percentage": 78.5000, "estimated_amount": 29412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 30322.3, "standard_charge_percentage": 78.5000, "estimated_amount": 30322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 30322.3, "standard_charge_percentage": 78.5000, "estimated_amount": 30322, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 37854.6, "standard_charge_percentage": 98.0000, "estimated_amount": 37854, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 34764.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 20377.2, "estimated_amount": 20377, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 32833, "standard_charge_percentage": 85.0000, "estimated_amount": 32833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 15792.3, "estimated_amount": 15792, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 30322.3, "standard_charge_percentage": 78.5000, "estimated_amount": 30322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 28806.2, "standard_charge_percentage": 78.5000, "estimated_amount": 28806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 28806.2, "standard_charge_percentage": 78.5000, "estimated_amount": 28806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 29412.6, "standard_charge_percentage": 78.5000, "estimated_amount": 29412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 29412.6, "standard_charge_percentage": 78.5000, "estimated_amount": 29412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 36695.8, "standard_charge_percentage": 95.0000, "estimated_amount": 36695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 33798.7, "standard_charge_percentage": 87.5000, "estimated_amount": 33798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 27896.5, "standard_charge_percentage": 78.5000, "estimated_amount": 27896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 28970.3, "standard_charge_percentage": 75.0000, "estimated_amount": 28970, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 19313.5, "standard_charge_percentage": 50.0000, "estimated_amount": 19313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 27290, "standard_charge_percentage": 78.5000, "estimated_amount": 27290, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 13993, "estimated_amount": 13992, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 10290.5, "estimated_amount": 10290, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11588.1, "standard_charge_percentage": 30.0000, "estimated_amount": 11588, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 10086.7, "estimated_amount": 10086, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 34764.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 38627.1, "standard_charge_percentage": 100.0000, "estimated_amount": 38627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 32833, "standard_charge_percentage": 85.0000, "estimated_amount": 32833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 21244.9, "standard_charge_percentage": 55.0000, "estimated_amount": 21244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 9523, "estimated_amount": 9523, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 34764.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34764, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 29412.6, "standard_charge_percentage": 78.5000, "estimated_amount": 29412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 19313.5, "standard_charge_percentage": 50.0000, "estimated_amount": 19313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15296.3, "standard_charge_percentage": 39.6000, "estimated_amount": 15296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 14264, "estimated_amount": 14264, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 36695.8, "standard_charge_percentage": 95.0000, "estimated_amount": 36695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 30019, "standard_charge_percentage": 78.5000, "estimated_amount": 30019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 9679.16, "estimated_amount": 9679, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 19313.5, "standard_charge_percentage": 50.0000, "estimated_amount": 19313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 6587, "estimated_amount": 6587, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 23176.3, "standard_charge_percentage": 60.0000, "estimated_amount": 23176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 30901.7, "standard_charge_percentage": 80.0000, "estimated_amount": 30901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 10392.4, "estimated_amount": 10392, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 15792.3, "estimated_amount": 15792, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 10188.6, "estimated_amount": 10188, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 29412.6, "standard_charge_percentage": 78.5000, "estimated_amount": 29412, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Translum Peripheral Atherectomy Iliac Artery Ea", "code_information": [ { "code": "0238T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 53836.5, "discounted_cash": 20972,"minimum": 6587,"maximum": 53836.5,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 26918.3, "standard_charge_percentage": 50.0000, "estimated_amount": 26918, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 40993.8, "standard_charge_percentage": 78.5000, "estimated_amount": 40993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 15971.3, "estimated_amount": 15971, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 13993, "estimated_amount": 13992, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 48452.8, "standard_charge_percentage": 90.0000, "estimated_amount": 48452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 42261.7, "standard_charge_percentage": 78.5000, "estimated_amount": 42261, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 6587, "estimated_amount": 6587, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 53836.5, "standard_charge_percentage": 100.0000, "estimated_amount": 53836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 48452.8, "standard_charge_percentage": 90.0000, "estimated_amount": 48452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 45761, "standard_charge_percentage": 85.0000, "estimated_amount": 45761, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 38880.7, "standard_charge_percentage": 78.5000, "estimated_amount": 38880, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 51144.7, "standard_charge_percentage": 95.0000, "estimated_amount": 51144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 22585.7, "estimated_amount": 22585, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 40148.6, "standard_charge_percentage": 78.5000, "estimated_amount": 40148, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 40993.8, "standard_charge_percentage": 78.5000, "estimated_amount": 40993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 40377.4, "standard_charge_percentage": 75.0000, "estimated_amount": 40377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 26918.3, "standard_charge_percentage": 50.0000, "estimated_amount": 26918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 38035.5, "standard_charge_percentage": 78.5000, "estimated_amount": 38035, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 21319.3, "standard_charge_percentage": 39.6000, "estimated_amount": 21319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 51144.7, "standard_charge_percentage": 95.0000, "estimated_amount": 51144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 40993.8, "standard_charge_percentage": 78.5000, "estimated_amount": 40993, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 41839, "standard_charge_percentage": 78.5000, "estimated_amount": 41839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 42261.7, "standard_charge_percentage": 78.5000, "estimated_amount": 42261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 32265.3, "estimated_amount": 32265, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 45761, "standard_charge_percentage": 85.0000, "estimated_amount": 45761, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 48452.8, "standard_charge_percentage": 90.0000, "estimated_amount": 48452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 40148.6, "standard_charge_percentage": 78.5000, "estimated_amount": 40148, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 42261.7, "standard_charge_percentage": 78.5000, "estimated_amount": 42261, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 52759.8, "standard_charge_percentage": 98.0000, "estimated_amount": 52759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 25005.6, "estimated_amount": 25005, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 29610.1, "standard_charge_percentage": 55.0000, "estimated_amount": 29610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 16151, "standard_charge_percentage": 30.0000, "estimated_amount": 16150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 9523, "estimated_amount": 9523, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 40993.8, "standard_charge_percentage": 78.5000, "estimated_amount": 40993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 16294, "estimated_amount": 16294, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 32301.9, "standard_charge_percentage": 60.0000, "estimated_amount": 32301, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 40993.8, "standard_charge_percentage": 78.5000, "estimated_amount": 40993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 15326, "estimated_amount": 15326, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 16455.3, "estimated_amount": 16455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 26918.3, "standard_charge_percentage": 50.0000, "estimated_amount": 26918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 43069.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 47106.9, "standard_charge_percentage": 87.5000, "estimated_amount": 47106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 25005.6, "estimated_amount": 25005, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 16132.7, "estimated_amount": 16132, "methodology": "fee schedule" }]}]} , { "description": "Hc Nfct Ds Rna 4 Targets Upper Respiratory Specimen", "code_information": [ { "code": "0241U", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 713.15, "discounted_cash": 185,"minimum": 40,"maximum": 713.15,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 543.03, "standard_charge_percentage": 78.5000, "estimated_amount": 543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 624.01, "standard_charge_percentage": 87.5000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 554.22, "standard_charge_percentage": 78.5000, "estimated_amount": 554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 145.48, "estimated_amount": 145, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 543.03, "standard_charge_percentage": 78.5000, "estimated_amount": 543, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 356.57, "standard_charge_percentage": 50.0000, "estimated_amount": 356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 392.23, "standard_charge_percentage": 55.0000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 606.18, "standard_charge_percentage": 85.0000, "estimated_amount": 606, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 698.89, "standard_charge_percentage": 98.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 641.84, "standard_charge_percentage": 90.0000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 559.82, "standard_charge_percentage": 78.5000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 641.84, "standard_charge_percentage": 90.0000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 138.2, "estimated_amount": 138, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 543.03, "standard_charge_percentage": 78.5000, "estimated_amount": 543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 213.94, "standard_charge_percentage": 30.0000, "estimated_amount": 213, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 606.18, "standard_charge_percentage": 85.0000, "estimated_amount": 606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 677.49, "standard_charge_percentage": 95.0000, "estimated_amount": 677, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 515.04, "standard_charge_percentage": 78.5000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 503.84, "standard_charge_percentage": 78.5000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 427.89, "standard_charge_percentage": 60.0000, "estimated_amount": 427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 559.82, "standard_charge_percentage": 78.5000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 641.84, "standard_charge_percentage": 90.0000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 40, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 543.03, "standard_charge_percentage": 78.5000, "estimated_amount": 543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 543.03, "standard_charge_percentage": 78.5000, "estimated_amount": 543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 713.15, "standard_charge_percentage": 100.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 356.57, "standard_charge_percentage": 50.0000, "estimated_amount": 356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 559.82, "standard_charge_percentage": 78.5000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 144.06, "estimated_amount": 144, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 531.83, "standard_charge_percentage": 78.5000, "estimated_amount": 531, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 221.08, "estimated_amount": 221, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 285.26, "estimated_amount": 285, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 316.64, "standard_charge_percentage": 44.4000, "estimated_amount": 316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 534.86, "standard_charge_percentage": 75.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 677.49, "standard_charge_percentage": 95.0000, "estimated_amount": 677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 221.08, "estimated_amount": 221, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 199.68, "estimated_amount": 199, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 282.41, "standard_charge_percentage": 39.6000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 356.57, "standard_charge_percentage": 50.0000, "estimated_amount": 356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 531.83, "standard_charge_percentage": 78.5000, "estimated_amount": 531, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 135.5, "estimated_amount": 135, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 141.2, "estimated_amount": 141, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 570.52, "standard_charge_percentage": 80.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 142.63, "estimated_amount": 142, "methodology": "fee schedule" }]}]} , { "description": "Perq lamotlam lumbar", "code_information": [ { "code": "0275T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 14907.8, "discounted_cash": 8343,"minimum": 3900,"maximum": 14907.8,"payers_information":[{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 6097.16, "estimated_amount": 6097, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 13417, "standard_charge_percentage": 90.0000, "estimated_amount": 13417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 6546.42, "estimated_amount": 6546, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 14162.4, "standard_charge_percentage": 95.0000, "estimated_amount": 14162, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 13417, "standard_charge_percentage": 90.0000, "estimated_amount": 13417, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 5936.16, "estimated_amount": 5936, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 11585.6, "standard_charge_percentage": 78.5000, "estimated_amount": 11585, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 12836.1, "estimated_amount": 12836, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 11180.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 11351.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11351, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 7453.9, "standard_charge_percentage": 50.0000, "estimated_amount": 7453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 8199.29, "standard_charge_percentage": 55.0000, "estimated_amount": 8199, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 14609.6, "standard_charge_percentage": 98.0000, "estimated_amount": 14609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 10766.4, "standard_charge_percentage": 78.5000, "estimated_amount": 10766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 12671.6, "standard_charge_percentage": 85.0000, "estimated_amount": 12671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 10532.4, "standard_charge_percentage": 78.5000, "estimated_amount": 10532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 13044.3, "standard_charge_percentage": 87.5000, "estimated_amount": 13044, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 6482.24, "estimated_amount": 6482, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 14907.8, "standard_charge_percentage": 100.0000, "estimated_amount": 14907, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 7453.9, "standard_charge_percentage": 50.0000, "estimated_amount": 7453, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 14162.4, "standard_charge_percentage": 95.0000, "estimated_amount": 14162, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 11702.6, "standard_charge_percentage": 78.5000, "estimated_amount": 11702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 11351.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 13417, "standard_charge_percentage": 90.0000, "estimated_amount": 13417, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 5903.49, "standard_charge_percentage": 39.6000, "estimated_amount": 5903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 11351.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11351, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 11117.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 11702.6, "standard_charge_percentage": 78.5000, "estimated_amount": 11702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 11117.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8985.28, "estimated_amount": 8985, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4472.34, "standard_charge_percentage": 30.0000, "estimated_amount": 4472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 12671.6, "standard_charge_percentage": 85.0000, "estimated_amount": 12671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 11702.6, "standard_charge_percentage": 78.5000, "estimated_amount": 11702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 11351.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 11351.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 11926.2, "standard_charge_percentage": 80.0000, "estimated_amount": 11926, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 7453.9, "standard_charge_percentage": 50.0000, "estimated_amount": 7453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 6353.88, "estimated_amount": 6353, "methodology": "fee schedule" }]}]} , { "description": "Hc Myocrd Sympathetic Innervaj Img Plnr Qual&Quant", "code_information": [ { "code": "0331T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3325.38, "discounted_cash": 1524,"minimum": 909,"maximum": 3325.38,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2992.84, "standard_charge_percentage": 90.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1114.22, "estimated_amount": 1114, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1662.69, "standard_charge_percentage": 50.0000, "estimated_amount": 1662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2610.42, "standard_charge_percentage": 78.5000, "estimated_amount": 2610, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2826.57, "standard_charge_percentage": 85.0000, "estimated_amount": 2826, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3159.11, "standard_charge_percentage": 95.0000, "estimated_amount": 3159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2494.03, "standard_charge_percentage": 75.0000, "estimated_amount": 2494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2909.71, "standard_charge_percentage": 87.5000, "estimated_amount": 2909, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2826.57, "standard_charge_percentage": 85.0000, "estimated_amount": 2826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2610.42, "standard_charge_percentage": 78.5000, "estimated_amount": 2610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3159.11, "standard_charge_percentage": 95.0000, "estimated_amount": 3159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2992.84, "standard_charge_percentage": 90.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3325.38, "standard_charge_percentage": 100.0000, "estimated_amount": 3325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1817.93, "estimated_amount": 1817, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1662.69, "standard_charge_percentage": 50.0000, "estimated_amount": 1662, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1316.85, "standard_charge_percentage": 39.6000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2479.9, "standard_charge_percentage": 78.5000, "estimated_amount": 2479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1476.47, "standard_charge_percentage": 44.4000, "estimated_amount": 1476, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2479.9, "standard_charge_percentage": 78.5000, "estimated_amount": 2479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1995.23, "standard_charge_percentage": 60.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1642, "estimated_amount": 1642, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662.69, "standard_charge_percentage": 50.0000, "estimated_amount": 1662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1196.32, "estimated_amount": 1196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2584.32, "standard_charge_percentage": 78.5000, "estimated_amount": 2584, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2992.84, "standard_charge_percentage": 90.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 997.61, "standard_charge_percentage": 30.0000, "estimated_amount": 997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2345.72, "estimated_amount": 2345, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1161.13, "estimated_amount": 1161, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1817.93, "estimated_amount": 1817, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1828.96, "standard_charge_percentage": 55.0000, "estimated_amount": 1828, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3258.87, "standard_charge_percentage": 98.0000, "estimated_amount": 3258, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2610.42, "standard_charge_percentage": 78.5000, "estimated_amount": 2610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1184.59, "estimated_amount": 1184, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2401.59, "standard_charge_percentage": 78.5000, "estimated_amount": 2401, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1229.98, "estimated_amount": 1229, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2349.38, "standard_charge_percentage": 78.5000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Myocrd Symp Innervaj Img Plnr Qual&Quant W/Spect", "code_information": [ { "code": "0332T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3325.38, "discounted_cash": 1524,"minimum": 909,"maximum": 3325.38,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2584.32, "standard_charge_percentage": 78.5000, "estimated_amount": 2584, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1817.93, "estimated_amount": 1817, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3258.87, "standard_charge_percentage": 98.0000, "estimated_amount": 3258, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2826.57, "standard_charge_percentage": 85.0000, "estimated_amount": 2826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2992.84, "standard_charge_percentage": 90.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2610.42, "standard_charge_percentage": 78.5000, "estimated_amount": 2610, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2992.84, "standard_charge_percentage": 90.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2479.9, "standard_charge_percentage": 78.5000, "estimated_amount": 2479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2349.38, "standard_charge_percentage": 78.5000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2826.57, "standard_charge_percentage": 85.0000, "estimated_amount": 2826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3159.11, "standard_charge_percentage": 95.0000, "estimated_amount": 3159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2610.42, "standard_charge_percentage": 78.5000, "estimated_amount": 2610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1161.13, "estimated_amount": 1161, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2479.9, "standard_charge_percentage": 78.5000, "estimated_amount": 2479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 997.61, "standard_charge_percentage": 30.0000, "estimated_amount": 997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2610.42, "standard_charge_percentage": 78.5000, "estimated_amount": 2610, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1828.96, "standard_charge_percentage": 55.0000, "estimated_amount": 1828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1196.32, "estimated_amount": 1196, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1316.85, "standard_charge_percentage": 39.6000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3325.38, "standard_charge_percentage": 100.0000, "estimated_amount": 3325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1114.22, "estimated_amount": 1114, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1476.47, "standard_charge_percentage": 44.4000, "estimated_amount": 1476, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2494.03, "standard_charge_percentage": 75.0000, "estimated_amount": 2494, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1662.69, "standard_charge_percentage": 50.0000, "estimated_amount": 1662, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1662.69, "standard_charge_percentage": 50.0000, "estimated_amount": 1662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2401.59, "standard_charge_percentage": 78.5000, "estimated_amount": 2401, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2992.84, "standard_charge_percentage": 90.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1184.59, "estimated_amount": 1184, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2345.72, "estimated_amount": 2345, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1229.98, "estimated_amount": 1229, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2909.71, "standard_charge_percentage": 87.5000, "estimated_amount": 2909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1817.93, "estimated_amount": 1817, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2660.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3159.11, "standard_charge_percentage": 95.0000, "estimated_amount": 3159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2532.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1642, "estimated_amount": 1642, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662.69, "standard_charge_percentage": 50.0000, "estimated_amount": 1662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1995.23, "standard_charge_percentage": 60.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1172.86, "estimated_amount": 1172, "methodology": "fee schedule" }]}]} , { "description": "Hc Ntrapx C Ffr W/3D Funcjl Map", "code_information": [ { "code": "0523T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 10045.2,"minimum": 511,"maximum": 10045.2,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3977.9, "standard_charge_percentage": 39.6000, "estimated_amount": 3977, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7648.92, "standard_charge_percentage": 78.5000, "estimated_amount": 7648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 7533.9, "standard_charge_percentage": 75.0000, "estimated_amount": 7533, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7648.92, "standard_charge_percentage": 78.5000, "estimated_amount": 7648, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 7254.64, "standard_charge_percentage": 78.5000, "estimated_amount": 7254, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7648.92, "standard_charge_percentage": 78.5000, "estimated_amount": 7648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 9040.68, "standard_charge_percentage": 90.0000, "estimated_amount": 9040, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 5022.6, "standard_charge_percentage": 50.0000, "estimated_amount": 5022, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7648.92, "standard_charge_percentage": 78.5000, "estimated_amount": 7648, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7648.92, "standard_charge_percentage": 78.5000, "estimated_amount": 7648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 9542.94, "standard_charge_percentage": 95.0000, "estimated_amount": 9542, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 8538.42, "standard_charge_percentage": 85.0000, "estimated_amount": 8538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4460.07, "standard_charge_percentage": 44.4000, "estimated_amount": 4460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 9040.68, "standard_charge_percentage": 90.0000, "estimated_amount": 9040, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7885.48, "standard_charge_percentage": 78.5000, "estimated_amount": 7885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 10045.2, "standard_charge_percentage": 100.0000, "estimated_amount": 10045, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7885.48, "standard_charge_percentage": 78.5000, "estimated_amount": 7885, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 5022.6, "standard_charge_percentage": 50.0000, "estimated_amount": 5022, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7806.63, "standard_charge_percentage": 78.5000, "estimated_amount": 7806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 7491.21, "standard_charge_percentage": 78.5000, "estimated_amount": 7491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5524.86, "standard_charge_percentage": 55.0000, "estimated_amount": 5524, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 6027.12, "standard_charge_percentage": 60.0000, "estimated_amount": 6027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9844.3, "standard_charge_percentage": 98.0000, "estimated_amount": 9844, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 7491.21, "standard_charge_percentage": 78.5000, "estimated_amount": 7491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 8538.42, "standard_charge_percentage": 85.0000, "estimated_amount": 8538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3013.56, "standard_charge_percentage": 30.0000, "estimated_amount": 3013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 7096.93, "standard_charge_percentage": 78.5000, "estimated_amount": 7096, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 9542.94, "standard_charge_percentage": 95.0000, "estimated_amount": 9542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5022.6, "standard_charge_percentage": 50.0000, "estimated_amount": 5022, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7885.48, "standard_charge_percentage": 78.5000, "estimated_amount": 7885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8789.55, "standard_charge_percentage": 87.5000, "estimated_amount": 8789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 9040.68, "standard_charge_percentage": 90.0000, "estimated_amount": 9040, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 8036.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8036, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "0707T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18619, "discounted_cash": 3789,"minimum": 306.83,"maximum": 18619,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18246.6, "standard_charge_percentage": 98.0000, "estimated_amount": 18246, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10240.4, "standard_charge_percentage": 55.0000, "estimated_amount": 10240, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16757.1, "standard_charge_percentage": 90.0000, "estimated_amount": 16757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14177.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13446.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2944.17, "estimated_amount": 2944, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15826.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14177.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17688, "standard_charge_percentage": 95.0000, "estimated_amount": 17688, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9309.49, "standard_charge_percentage": 50.0000, "estimated_amount": 9309, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14615.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14615, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9309.49, "standard_charge_percentage": 50.0000, "estimated_amount": 9309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9309.49, "standard_charge_percentage": 50.0000, "estimated_amount": 9309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2769.27, "estimated_amount": 2769, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16757.1, "standard_charge_percentage": 90.0000, "estimated_amount": 16757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14177.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14177, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13154.3, "standard_charge_percentage": 78.5000, "estimated_amount": 13154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14177.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 13964.2, "standard_charge_percentage": 75.0000, "estimated_amount": 13964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5585.69, "standard_charge_percentage": 30.0000, "estimated_amount": 5585, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14469.7, "standard_charge_percentage": 78.5000, "estimated_amount": 14469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7373.12, "standard_charge_percentage": 39.6000, "estimated_amount": 7373, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2885.87, "estimated_amount": 2885, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15826.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16757.1, "standard_charge_percentage": 90.0000, "estimated_amount": 16757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5830.04, "estimated_amount": 5830, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13885.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17688, "standard_charge_percentage": 95.0000, "estimated_amount": 17688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 4518.28, "estimated_amount": 4518, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2973.32, "estimated_amount": 2973, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16291.6, "standard_charge_percentage": 87.5000, "estimated_amount": 16291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13885.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18619, "standard_charge_percentage": 100.0000, "estimated_amount": 18618, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14615.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14615, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14615.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14615, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14895.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4081.03, "estimated_amount": 4081, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 4518.28, "estimated_amount": 4518, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14177.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14177, "methodology": "percent of total billed charges" }]}]} , { "description": "FNA BX US GUIDANCE 1ST LESION", "code_information": [ { "code": "10005", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2964.05, "discounted_cash": 821,"minimum": 93.71,"maximum": 2964.05,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2210.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2210, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2519.44, "standard_charge_percentage": 85.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1185.62, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1185, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 93.71, "estimated_amount": 93, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2223.04, "standard_charge_percentage": 75.0000, "estimated_amount": 2223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2094.1, "standard_charge_percentage": 78.5000, "estimated_amount": 2094, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 889.22, "standard_charge_percentage": 30.0000, "estimated_amount": 889, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2140.64, "standard_charge_percentage": 78.5000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1173.76, "standard_charge_percentage": 39.6000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2904.77, "standard_charge_percentage": 98.0000, "estimated_amount": 2904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1778.43, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2593.54, "standard_charge_percentage": 87.5000, "estimated_amount": 2593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2964.05, "standard_charge_percentage": 100.0000, "estimated_amount": 2964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 805.47, "estimated_amount": 805, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1630.23, "standard_charge_percentage": 55.0000, "estimated_amount": 1630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2303.51, "standard_charge_percentage": 78.5000, "estimated_amount": 2303, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2210.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2210, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2815.85, "standard_charge_percentage": 95.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2815.85, "standard_charge_percentage": 95.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 93.71, "estimated_amount": 93, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2519.44, "standard_charge_percentage": 85.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" }]}]} , { "description": "FNA BX US GDN EA ADDL LESION", "code_information": [ { "code": "10006", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 512.5,"minimum": 63.89,"maximum": 512.5,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 390.24, "standard_charge_percentage": 78.5000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 448.44, "standard_charge_percentage": 87.5000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 390.24, "standard_charge_percentage": 78.5000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 486.88, "standard_charge_percentage": 95.0000, "estimated_amount": 486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 435.63, "standard_charge_percentage": 85.0000, "estimated_amount": 435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 362.08, "standard_charge_percentage": 78.5000, "estimated_amount": 362, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 202.95, "standard_charge_percentage": 39.6000, "estimated_amount": 202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 390.24, "standard_charge_percentage": 78.5000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 461.25, "standard_charge_percentage": 90.0000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 153.75, "standard_charge_percentage": 30.0000, "estimated_amount": 153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 307.5, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 307, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 502.25, "standard_charge_percentage": 98.0000, "estimated_amount": 502, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 256.25, "standard_charge_percentage": 50.0000, "estimated_amount": 256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 461.25, "standard_charge_percentage": 90.0000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 402.31, "standard_charge_percentage": 78.5000, "estimated_amount": 402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 382.2, "standard_charge_percentage": 78.5000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 390.24, "standard_charge_percentage": 78.5000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 512.5, "standard_charge_percentage": 100.0000, "estimated_amount": 512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 398.29, "standard_charge_percentage": 78.5000, "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 382.2, "standard_charge_percentage": 78.5000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 390.24, "standard_charge_percentage": 78.5000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 281.88, "standard_charge_percentage": 55.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 63.89, "estimated_amount": 63, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 402.31, "standard_charge_percentage": 78.5000, "estimated_amount": 402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 461.25, "standard_charge_percentage": 90.0000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 370.13, "standard_charge_percentage": 78.5000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 63.89, "estimated_amount": 63, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 435.63, "standard_charge_percentage": 85.0000, "estimated_amount": 435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 205, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 384.38, "standard_charge_percentage": 75.0000, "estimated_amount": 384, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 512.5, "estimated_amount": 512, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 402.31, "standard_charge_percentage": 78.5000, "estimated_amount": 402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 256.25, "standard_charge_percentage": 50.0000, "estimated_amount": 256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 410, "standard_charge_percentage": 80.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 256.25, "standard_charge_percentage": 50.0000, "estimated_amount": 256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 486.88, "standard_charge_percentage": 95.0000, "estimated_amount": 486, "methodology": "percent of total billed charges" }]}]} , { "description": "Fna bx wfluor gdn 1st les", "code_information": [ { "code": "10007", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2896.7, "discounted_cash": 821,"minimum": 120.19,"maximum": 2896.7,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2462.19, "standard_charge_percentage": 85.0000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1147.09, "standard_charge_percentage": 39.6000, "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 869.01, "standard_charge_percentage": 30.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1593.18, "standard_charge_percentage": 55.0000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 120.19, "estimated_amount": 120, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2751.86, "standard_charge_percentage": 95.0000, "estimated_amount": 2751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2046.52, "standard_charge_percentage": 78.5000, "estimated_amount": 2046, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2534.61, "standard_charge_percentage": 87.5000, "estimated_amount": 2534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2251.17, "standard_charge_percentage": 78.5000, "estimated_amount": 2251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2160.21, "standard_charge_percentage": 78.5000, "estimated_amount": 2160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2838.77, "standard_charge_percentage": 98.0000, "estimated_amount": 2838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1158.68, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1158, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2092, "standard_charge_percentage": 78.5000, "estimated_amount": 2092, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 120.19, "estimated_amount": 120, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2896.7, "standard_charge_percentage": 100.0000, "estimated_amount": 2896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2160.21, "standard_charge_percentage": 78.5000, "estimated_amount": 2160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2172.53, "standard_charge_percentage": 75.0000, "estimated_amount": 2172, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2751.86, "standard_charge_percentage": 95.0000, "estimated_amount": 2751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2462.19, "standard_charge_percentage": 85.0000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1738.02, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 805.47, "estimated_amount": 805, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Fine Needle Aspiration Bx W/Fluor Gdn Ea Addl", "code_information": [ { "code": "10008", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 500,"minimum": 78.42,"maximum": 500,"payers_information":[{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 150, "standard_charge_percentage": 30.0000, "estimated_amount": 150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 353.25, "standard_charge_percentage": 78.5000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 375, "standard_charge_percentage": 75.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 490, "standard_charge_percentage": 98.0000, "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 78.42, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 275, "standard_charge_percentage": 55.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 500, "standard_charge_percentage": 100.0000, "estimated_amount": 500, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 361.1, "standard_charge_percentage": 78.5000, "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 300, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 78.42, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 437.5, "standard_charge_percentage": 87.5000, "estimated_amount": 437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 200, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 388.57, "standard_charge_percentage": 78.5000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 198, "standard_charge_percentage": 39.6000, "estimated_amount": 198, "methodology": "percent of total billed charges" }]}]} , { "description": "Fna bx wct gdn 1st les", "code_information": [ { "code": "10009", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2896.7, "discounted_cash": 821,"minimum": 146.11,"maximum": 2896.7,"payers_information":[{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1158.68, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2462.19, "standard_charge_percentage": 85.0000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2160.21, "standard_charge_percentage": 78.5000, "estimated_amount": 2160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 869.01, "standard_charge_percentage": 30.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 146.11, "estimated_amount": 146, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2751.86, "standard_charge_percentage": 95.0000, "estimated_amount": 2751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1593.18, "standard_charge_percentage": 55.0000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2092, "standard_charge_percentage": 78.5000, "estimated_amount": 2092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1738.02, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1738, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2838.77, "standard_charge_percentage": 98.0000, "estimated_amount": 2838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2896.7, "standard_charge_percentage": 100.0000, "estimated_amount": 2896, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2462.19, "standard_charge_percentage": 85.0000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 805.47, "estimated_amount": 805, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1147.09, "standard_charge_percentage": 39.6000, "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 146.11, "estimated_amount": 146, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2160.21, "standard_charge_percentage": 78.5000, "estimated_amount": 2160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2751.86, "standard_charge_percentage": 95.0000, "estimated_amount": 2751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2046.52, "standard_charge_percentage": 78.5000, "estimated_amount": 2046, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2534.61, "standard_charge_percentage": 87.5000, "estimated_amount": 2534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2251.17, "standard_charge_percentage": 78.5000, "estimated_amount": 2251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2172.53, "standard_charge_percentage": 75.0000, "estimated_amount": 2172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" }]}]} , { "description": "FNA BX CT GDN EA ADDL LESION", "code_information": [ { "code": "10010", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 500,"minimum": 106.79,"maximum": 500,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 388.57, "standard_charge_percentage": 78.5000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 200, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 200, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 490, "standard_charge_percentage": 98.0000, "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 300, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 106.79, "estimated_amount": 106, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 353.25, "standard_charge_percentage": 78.5000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 198, "standard_charge_percentage": 39.6000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 150, "standard_charge_percentage": 30.0000, "estimated_amount": 150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 437.5, "standard_charge_percentage": 87.5000, "estimated_amount": 437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 375, "standard_charge_percentage": 75.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 275, "standard_charge_percentage": 55.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 500, "standard_charge_percentage": 100.0000, "estimated_amount": 500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 106.79, "estimated_amount": 106, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 361.1, "standard_charge_percentage": 78.5000, "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Fine Needle Aspiration Bx W/Mr Gdn 1St Lesion", "code_information": [ { "code": "10011", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2896.7, "discounted_cash": 821,"minimum": 139.92,"maximum": 2896.7,"payers_information":[{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 139.92, "estimated_amount": 139, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2092, "standard_charge_percentage": 78.5000, "estimated_amount": 2092, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2160.21, "standard_charge_percentage": 78.5000, "estimated_amount": 2160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2160.21, "standard_charge_percentage": 78.5000, "estimated_amount": 2160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2896.7, "standard_charge_percentage": 100.0000, "estimated_amount": 2896, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2462.19, "standard_charge_percentage": 85.0000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1738.02, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1738, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2046.52, "standard_charge_percentage": 78.5000, "estimated_amount": 2046, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1158.68, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2751.86, "standard_charge_percentage": 95.0000, "estimated_amount": 2751, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2462.19, "standard_charge_percentage": 85.0000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1593.18, "standard_charge_percentage": 55.0000, "estimated_amount": 1593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2751.86, "standard_charge_percentage": 95.0000, "estimated_amount": 2751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 139.92, "estimated_amount": 139, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 869.01, "standard_charge_percentage": 30.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2607.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2607, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2838.77, "standard_charge_percentage": 98.0000, "estimated_amount": 2838, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1147.09, "standard_charge_percentage": 39.6000, "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2205.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2317.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2251.17, "standard_charge_percentage": 78.5000, "estimated_amount": 2251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2273.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1448.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2172.53, "standard_charge_percentage": 75.0000, "estimated_amount": 2172, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 805.47, "estimated_amount": 805, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2534.61, "standard_charge_percentage": 87.5000, "estimated_amount": 2534, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Fine Needle Aspiration Bx W/Mr Gdn Ea Addl", "code_information": [ { "code": "10012", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 500,"minimum": 139.92,"maximum": 500,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 361.1, "standard_charge_percentage": 78.5000, "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 437.5, "standard_charge_percentage": 87.5000, "estimated_amount": 437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 353.25, "standard_charge_percentage": 78.5000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 139.92, "estimated_amount": 139, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 275, "standard_charge_percentage": 55.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 375, "standard_charge_percentage": 75.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 198, "standard_charge_percentage": 39.6000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 200, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 200, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 490, "standard_charge_percentage": 98.0000, "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 388.57, "standard_charge_percentage": 78.5000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 300, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 139.92, "estimated_amount": 139, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 500, "standard_charge_percentage": 100.0000, "estimated_amount": 500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 150, "standard_charge_percentage": 30.0000, "estimated_amount": 150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" }]}]} , { "description": "ENDOVENOUS RF VEIN ADD-ON", "code_information": [ { "code": "10021", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 494.47, "discounted_cash": 466,"minimum": 148.34,"maximum": 494.47,"payers_information":[{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 247.24, "standard_charge_percentage": 50.0000, "estimated_amount": 247, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 368.75, "standard_charge_percentage": 78.5000, "estimated_amount": 368, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 445.02, "standard_charge_percentage": 90.0000, "estimated_amount": 445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 469.75, "standard_charge_percentage": 95.0000, "estimated_amount": 469, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 420.3, "standard_charge_percentage": 85.0000, "estimated_amount": 420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 376.51, "standard_charge_percentage": 78.5000, "estimated_amount": 376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 368.75, "standard_charge_percentage": 78.5000, "estimated_amount": 368, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 271.96, "standard_charge_percentage": 55.0000, "estimated_amount": 271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 376.51, "standard_charge_percentage": 78.5000, "estimated_amount": 376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 494.47, "standard_charge_percentage": 100.0000, "estimated_amount": 494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 432.66, "standard_charge_percentage": 87.5000, "estimated_amount": 432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 197.79, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 349.34, "standard_charge_percentage": 78.5000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 494.47, "estimated_amount": 494, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 357.11, "standard_charge_percentage": 78.5000, "estimated_amount": 357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 296.68, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 484.58, "standard_charge_percentage": 98.0000, "estimated_amount": 484, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 469.75, "standard_charge_percentage": 95.0000, "estimated_amount": 469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 388.16, "standard_charge_percentage": 78.5000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 384.28, "standard_charge_percentage": 78.5000, "estimated_amount": 384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 376.51, "standard_charge_percentage": 78.5000, "estimated_amount": 376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 247.24, "standard_charge_percentage": 50.0000, "estimated_amount": 247, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 420.3, "standard_charge_percentage": 85.0000, "estimated_amount": 420, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 195.81, "standard_charge_percentage": 39.6000, "estimated_amount": 195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 494.47, "estimated_amount": 494, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 376.51, "standard_charge_percentage": 78.5000, "estimated_amount": 376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 445.02, "standard_charge_percentage": 90.0000, "estimated_amount": 445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 370.85, "standard_charge_percentage": 75.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 445.02, "standard_charge_percentage": 90.0000, "estimated_amount": 445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 494.47, "estimated_amount": 494, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 494.47, "estimated_amount": 494, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 388.16, "standard_charge_percentage": 78.5000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 395.58, "standard_charge_percentage": 80.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 247.24, "standard_charge_percentage": 50.0000, "estimated_amount": 247, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 148.34, "standard_charge_percentage": 30.0000, "estimated_amount": 148, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 388.16, "standard_charge_percentage": 78.5000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 494.47, "estimated_amount": 494, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 376.51, "standard_charge_percentage": 78.5000, "estimated_amount": 376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 494.47, "estimated_amount": 494, "methodology": "fee schedule" }]}]} , { "description": "Img gid flu coll drg sft tis", "code_information": [ { "code": "10030", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1996.5, "discounted_cash": 821,"minimum": 243.24,"maximum": 1996.5,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1400.43, "estimated_amount": 1400, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1697.03, "standard_charge_percentage": 85.0000, "estimated_amount": 1697, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1497.38, "standard_charge_percentage": 75.0000, "estimated_amount": 1497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1488.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1567.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1520.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1410.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1197.9, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1551.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1896.67, "standard_charge_percentage": 95.0000, "estimated_amount": 1896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1746.94, "standard_charge_percentage": 87.5000, "estimated_amount": 1746, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1956.57, "standard_charge_percentage": 98.0000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 998.25, "standard_charge_percentage": 50.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1488.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 598.95, "standard_charge_percentage": 30.0000, "estimated_amount": 598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1520.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 798.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1520.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1896.67, "standard_charge_percentage": 95.0000, "estimated_amount": 1896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 998.25, "standard_charge_percentage": 50.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1567.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 998.25, "standard_charge_percentage": 50.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1796.85, "standard_charge_percentage": 90.0000, "estimated_amount": 1796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1796.85, "standard_charge_percentage": 90.0000, "estimated_amount": 1796, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1441.87, "standard_charge_percentage": 78.5000, "estimated_amount": 1441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1796.85, "standard_charge_percentage": 90.0000, "estimated_amount": 1796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1567.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1996.5, "standard_charge_percentage": 100.0000, "estimated_amount": 1996, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1520.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1697.03, "standard_charge_percentage": 85.0000, "estimated_amount": 1697, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1098.08, "standard_charge_percentage": 55.0000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1520.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1520, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 790.61, "standard_charge_percentage": 39.6000, "estimated_amount": 790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1597.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" }]}]} , { "description": "Acne surgery", "code_information": [ { "code": "10040", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 353.49, "discounted_cash": 232,"minimum": 106.05,"maximum": 353.49,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 353.49, "estimated_amount": 353, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 249.74, "standard_charge_percentage": 78.5000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 300.47, "standard_charge_percentage": 85.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 318.14, "standard_charge_percentage": 90.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 263.62, "standard_charge_percentage": 78.5000, "estimated_amount": 263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 277.49, "standard_charge_percentage": 78.5000, "estimated_amount": 277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 194.42, "standard_charge_percentage": 55.0000, "estimated_amount": 194, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 106.05, "standard_charge_percentage": 30.0000, "estimated_amount": 106, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 269.16, "standard_charge_percentage": 78.5000, "estimated_amount": 269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 353.49, "estimated_amount": 353, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 269.16, "standard_charge_percentage": 78.5000, "estimated_amount": 269, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 269.16, "standard_charge_percentage": 78.5000, "estimated_amount": 269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 265.12, "standard_charge_percentage": 75.0000, "estimated_amount": 265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 212.09, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 353.49, "standard_charge_percentage": 100.0000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 263.62, "standard_charge_percentage": 78.5000, "estimated_amount": 263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 269.16, "standard_charge_percentage": 78.5000, "estimated_amount": 269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 255.29, "standard_charge_percentage": 78.5000, "estimated_amount": 255, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 269.16, "standard_charge_percentage": 78.5000, "estimated_amount": 269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 139.98, "standard_charge_percentage": 39.6000, "estimated_amount": 139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 335.82, "standard_charge_percentage": 95.0000, "estimated_amount": 335, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 300.47, "standard_charge_percentage": 85.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 277.49, "standard_charge_percentage": 78.5000, "estimated_amount": 277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 335.82, "standard_charge_percentage": 95.0000, "estimated_amount": 335, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 176.75, "standard_charge_percentage": 50.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 141.4, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 141, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 309.3, "standard_charge_percentage": 87.5000, "estimated_amount": 309, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 277.49, "standard_charge_percentage": 78.5000, "estimated_amount": 277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 274.71, "standard_charge_percentage": 78.5000, "estimated_amount": 274, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 176.75, "standard_charge_percentage": 50.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 346.42, "standard_charge_percentage": 98.0000, "estimated_amount": 346, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 318.14, "standard_charge_percentage": 90.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 176.75, "standard_charge_percentage": 50.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 282.79, "standard_charge_percentage": 80.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 318.14, "standard_charge_percentage": 90.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Incision & Drain Skin Abscess Simple", "code_information": [ { "code": "10060", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 843.4, "discounted_cash": 232,"minimum": 169.58,"maximum": 19507.5,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 333.99, "standard_charge_percentage": 39.6000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7724.97, "standard_charge_percentage": 39.6000, "estimated_amount": 7724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13782, "standard_charge_percentage": 78.5000, "estimated_amount": 13782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18532.1, "standard_charge_percentage": 95.0000, "estimated_amount": 18532, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 628.97, "standard_charge_percentage": 78.5000, "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 826.53, "standard_charge_percentage": 98.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 801.23, "standard_charge_percentage": 95.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 337.36, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 628.97, "standard_charge_percentage": 78.5000, "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 801.23, "standard_charge_percentage": 95.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14547.7, "standard_charge_percentage": 78.5000, "estimated_amount": 14547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18532.1, "standard_charge_percentage": 95.0000, "estimated_amount": 18532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 253.02, "standard_charge_percentage": 30.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15313.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15313, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17556.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17556.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15313.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17556.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17556, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 609.1, "standard_charge_percentage": 78.5000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 655.45, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9753.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9753, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16581.4, "standard_charge_percentage": 85.0000, "estimated_amount": 16581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 506.04, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 506, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16581.4, "standard_charge_percentage": 85.0000, "estimated_amount": 16581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14088.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15160.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15160, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 463.87, "standard_charge_percentage": 55.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5852.25, "standard_charge_percentage": 30.0000, "estimated_amount": 5852, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 716.89, "standard_charge_percentage": 85.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14630.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 843.4, "standard_charge_percentage": 100.0000, "estimated_amount": 843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 737.98, "standard_charge_percentage": 87.5000, "estimated_amount": 737, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17069.1, "standard_charge_percentage": 87.5000, "estimated_amount": 17069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14547.7, "standard_charge_percentage": 78.5000, "estimated_amount": 14547, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9753.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19507.5, "standard_charge_percentage": 100.0000, "estimated_amount": 19507, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 595.86, "standard_charge_percentage": 78.5000, "estimated_amount": 595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10729.1, "standard_charge_percentage": 55.0000, "estimated_amount": 10729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15313.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15313, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 716.89, "standard_charge_percentage": 85.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9753.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 632.55, "standard_charge_percentage": 75.0000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19117.3, "standard_charge_percentage": 98.0000, "estimated_amount": 19117, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" }]}]} , { "description": "I&D Abscess Comp/Multiple", "code_information": [ { "code": "10061", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19507.5, "discounted_cash": 466,"minimum": 208.58,"maximum": 19507.5,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19117.3, "standard_charge_percentage": 98.0000, "estimated_amount": 19117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15313.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1021.39, "standard_charge_percentage": 78.5000, "estimated_amount": 1021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 753.29, "standard_charge_percentage": 55.0000, "estimated_amount": 753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 684.81, "standard_charge_percentage": 50.0000, "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 410.89, "standard_charge_percentage": 30.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1164.18, "standard_charge_percentage": 85.0000, "estimated_amount": 1164, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16581.4, "standard_charge_percentage": 85.0000, "estimated_amount": 16581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17556.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 989.14, "standard_charge_percentage": 78.5000, "estimated_amount": 989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17556.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17556, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1232.66, "standard_charge_percentage": 90.0000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10729.1, "standard_charge_percentage": 55.0000, "estimated_amount": 10729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1064.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1064, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1042.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 547.85, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16581.4, "standard_charge_percentage": 85.0000, "estimated_amount": 16581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9753.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9753, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 684.81, "standard_charge_percentage": 50.0000, "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1301.14, "standard_charge_percentage": 95.0000, "estimated_amount": 1301, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9753.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 684.81, "standard_charge_percentage": 50.0000, "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1042.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1027.21, "standard_charge_percentage": 75.0000, "estimated_amount": 1027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14547.7, "standard_charge_percentage": 78.5000, "estimated_amount": 14547, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14088.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1042.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15160.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15160, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1042.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1075.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5852.25, "standard_charge_percentage": 30.0000, "estimated_amount": 5852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15313.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14630.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14630, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17556.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18532.1, "standard_charge_percentage": 95.0000, "estimated_amount": 18532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1164.18, "standard_charge_percentage": 85.0000, "estimated_amount": 1164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9753.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14854, "standard_charge_percentage": 78.5000, "estimated_amount": 14853, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1075.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1021.39, "standard_charge_percentage": 78.5000, "estimated_amount": 1021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14547.7, "standard_charge_percentage": 78.5000, "estimated_amount": 14547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15606, "standard_charge_percentage": 80.0000, "estimated_amount": 15606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18532.1, "standard_charge_percentage": 95.0000, "estimated_amount": 18532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1042.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1369.62, "standard_charge_percentage": 100.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1232.66, "standard_charge_percentage": 90.0000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17069.1, "standard_charge_percentage": 87.5000, "estimated_amount": 17069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 821.77, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1301.14, "standard_charge_percentage": 95.0000, "estimated_amount": 1301, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1232.66, "standard_charge_percentage": 90.0000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7724.97, "standard_charge_percentage": 39.6000, "estimated_amount": 7724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1095.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 542.37, "standard_charge_percentage": 39.6000, "estimated_amount": 542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1075.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19507.5, "standard_charge_percentage": 100.0000, "estimated_amount": 19507, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1342.23, "standard_charge_percentage": 98.0000, "estimated_amount": 1342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13782, "standard_charge_percentage": 78.5000, "estimated_amount": 13782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1198.42, "standard_charge_percentage": 87.5000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15313.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 967.64, "standard_charge_percentage": 78.5000, "estimated_amount": 967, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Incision & Drain Pilonidal Cyst Simpl", "code_information": [ { "code": "10080", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2964.05, "discounted_cash": 821,"minimum": 195.04,"maximum": 2964.05,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1185.62, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2815.85, "standard_charge_percentage": 95.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 889.22, "standard_charge_percentage": 30.0000, "estimated_amount": 889, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2815.85, "standard_charge_percentage": 95.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1630.23, "standard_charge_percentage": 55.0000, "estimated_amount": 1630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2210.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2210, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1173.76, "standard_charge_percentage": 39.6000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2964.05, "standard_charge_percentage": 100.0000, "estimated_amount": 2964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2904.77, "standard_charge_percentage": 98.0000, "estimated_amount": 2904, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2519.44, "standard_charge_percentage": 85.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2140.64, "standard_charge_percentage": 78.5000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2223.04, "standard_charge_percentage": 75.0000, "estimated_amount": 2223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 195.04, "estimated_amount": 195, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1778.43, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2303.51, "standard_charge_percentage": 78.5000, "estimated_amount": 2303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2210.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2519.44, "standard_charge_percentage": 85.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2593.54, "standard_charge_percentage": 87.5000, "estimated_amount": 2593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2094.1, "standard_charge_percentage": 78.5000, "estimated_amount": 2094, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 195.04, "estimated_amount": 195, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" }]}]} , { "description": "RMVL TUNNLED CV CATH W/PORT", "code_information": [ { "code": "10081", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2354.82, "discounted_cash": 821,"minimum": 289.77,"maximum": 2354.82,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1177.41, "standard_charge_percentage": 50.0000, "estimated_amount": 1177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1400.43, "estimated_amount": 1400, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1848.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2237.08, "standard_charge_percentage": 95.0000, "estimated_amount": 2237, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1793.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2060.47, "standard_charge_percentage": 87.5000, "estimated_amount": 2060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1766.12, "standard_charge_percentage": 75.0000, "estimated_amount": 1766, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 932.51, "standard_charge_percentage": 39.6000, "estimated_amount": 932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2119.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1793.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2237.08, "standard_charge_percentage": 95.0000, "estimated_amount": 2237, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1177.41, "standard_charge_percentage": 50.0000, "estimated_amount": 1177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1756.11, "standard_charge_percentage": 78.5000, "estimated_amount": 1756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1793.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1412.89, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2001.6, "standard_charge_percentage": 85.0000, "estimated_amount": 2001, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 289.77, "estimated_amount": 289, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2307.72, "standard_charge_percentage": 98.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1848.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1756.11, "standard_charge_percentage": 78.5000, "estimated_amount": 1756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2119.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1830.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1830, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1663.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1848.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1177.41, "standard_charge_percentage": 50.0000, "estimated_amount": 1177, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1793.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2001.6, "standard_charge_percentage": 85.0000, "estimated_amount": 2001, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2354.82, "standard_charge_percentage": 100.0000, "estimated_amount": 2354, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 289.77, "estimated_amount": 289, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1793.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1700.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 941.93, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2119.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1295.15, "standard_charge_percentage": 55.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 706.45, "standard_charge_percentage": 30.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" }]}]} , { "description": "Inc&rmvl fb subq tiss smpl", "code_information": [ { "code": "10120", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 208.58,"maximum": 19254.2,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" }]}]} , { "description": "I&R FOREIGN BDY SUBQ TISS SMPL", "code_information": [ { "code": "10140", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6830.25, "discounted_cash": 1892,"minimum": 325.58,"maximum": 21442.8,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 16327.6, "standard_charge_percentage": 78.5000, "estimated_amount": 16327, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 15149.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15149, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 21442.8, "standard_charge_percentage": 100.0000, "estimated_amount": 21442, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 15486, "standard_charge_percentage": 78.5000, "estimated_amount": 15485, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8491.35, "standard_charge_percentage": 39.6000, "estimated_amount": 8491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2049.07, "standard_charge_percentage": 30.0000, "estimated_amount": 2049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 15991, "standard_charge_percentage": 78.5000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2704.78, "standard_charge_percentage": 39.6000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4932.81, "standard_charge_percentage": 78.5000, "estimated_amount": 4932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 16832.6, "standard_charge_percentage": 78.5000, "estimated_amount": 16832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16832.6, "standard_charge_percentage": 78.5000, "estimated_amount": 16832, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1400.43, "estimated_amount": 1400, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10721.4, "standard_charge_percentage": 50.0000, "estimated_amount": 10721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 18226.4, "standard_charge_percentage": 85.0000, "estimated_amount": 18226, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6830.25, "standard_charge_percentage": 100.0000, "estimated_amount": 6830, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6693.65, "standard_charge_percentage": 98.0000, "estimated_amount": 6693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 16082.1, "standard_charge_percentage": 75.0000, "estimated_amount": 16082, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 21013.9, "standard_charge_percentage": 98.0000, "estimated_amount": 21013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5122.69, "standard_charge_percentage": 75.0000, "estimated_amount": 5122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 18762.5, "standard_charge_percentage": 87.5000, "estimated_amount": 18762, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3756.64, "standard_charge_percentage": 55.0000, "estimated_amount": 3756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10721.4, "standard_charge_percentage": 50.0000, "estimated_amount": 10721, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2732.1, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2732, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 16664.3, "standard_charge_percentage": 78.5000, "estimated_amount": 16664, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 18226.4, "standard_charge_percentage": 85.0000, "estimated_amount": 18226, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 16832.6, "standard_charge_percentage": 78.5000, "estimated_amount": 16832, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 19298.5, "standard_charge_percentage": 90.0000, "estimated_amount": 19298, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 20370.7, "standard_charge_percentage": 95.0000, "estimated_amount": 20370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4825.57, "standard_charge_percentage": 78.5000, "estimated_amount": 4825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 16327.6, "standard_charge_percentage": 78.5000, "estimated_amount": 16327, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 16327.6, "standard_charge_percentage": 78.5000, "estimated_amount": 16327, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5976.47, "standard_charge_percentage": 87.5000, "estimated_amount": 5976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 19298.5, "standard_charge_percentage": 90.0000, "estimated_amount": 19298, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 15991, "standard_charge_percentage": 78.5000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6432.84, "standard_charge_percentage": 30.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10721.4, "standard_charge_percentage": 50.0000, "estimated_amount": 10721, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 19298.5, "standard_charge_percentage": 90.0000, "estimated_amount": 19298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11793.5, "standard_charge_percentage": 55.0000, "estimated_amount": 11793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 16327.6, "standard_charge_percentage": 78.5000, "estimated_amount": 16327, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 16327.6, "standard_charge_percentage": 78.5000, "estimated_amount": 16327, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 20370.7, "standard_charge_percentage": 95.0000, "estimated_amount": 20370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5308.13, "standard_charge_percentage": 78.5000, "estimated_amount": 5308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 17154.2, "standard_charge_percentage": 80.0000, "estimated_amount": 17154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" }]}]} , { "description": "EXC BEN LES SC/NK/H/F0.6-1.0CM", "code_information": [ { "code": "10160", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 208.58,"maximum": 1679.85,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" }]}]} , { "description": "I&d complex po wound infctj", "code_information": [ { "code": "10180", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3472.16, "discounted_cash": 3342,"minimum": 243.24,"maximum": 23483.8,"payers_information":[{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12916.1, "standard_charge_percentage": 55.0000, "estimated_amount": 12916, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11741.9, "standard_charge_percentage": 50.0000, "estimated_amount": 11741, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 21135.4, "standard_charge_percentage": 90.0000, "estimated_amount": 21135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3124.94, "standard_charge_percentage": 90.0000, "estimated_amount": 3124, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3124.94, "standard_charge_percentage": 90.0000, "estimated_amount": 3124, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 16591.3, "standard_charge_percentage": 78.5000, "estimated_amount": 16591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 17881.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17612.8, "standard_charge_percentage": 75.0000, "estimated_amount": 17612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2643.88, "standard_charge_percentage": 78.5000, "estimated_amount": 2643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2589.36, "standard_charge_percentage": 78.5000, "estimated_amount": 2589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 19961.2, "standard_charge_percentage": 85.0000, "estimated_amount": 19961, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1736.08, "standard_charge_percentage": 50.0000, "estimated_amount": 1736, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3472.16, "estimated_amount": 3472, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1374.98, "standard_charge_percentage": 39.6000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 18434.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 17513, "standard_charge_percentage": 78.5000, "estimated_amount": 17513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 21135.4, "standard_charge_percentage": 90.0000, "estimated_amount": 21135, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 23483.8, "standard_charge_percentage": 100.0000, "estimated_amount": 23483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1736.08, "standard_charge_percentage": 50.0000, "estimated_amount": 1736, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3038.14, "standard_charge_percentage": 87.5000, "estimated_amount": 3038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3124.94, "standard_charge_percentage": 90.0000, "estimated_amount": 3124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3472.16, "estimated_amount": 3472, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 17881.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2951.34, "standard_charge_percentage": 85.0000, "estimated_amount": 2951, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 18434.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2725.65, "standard_charge_percentage": 78.5000, "estimated_amount": 2725, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16960, "standard_charge_percentage": 78.5000, "estimated_amount": 16960, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1736.08, "standard_charge_percentage": 50.0000, "estimated_amount": 1736, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 22309.6, "standard_charge_percentage": 95.0000, "estimated_amount": 22309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2643.88, "standard_charge_percentage": 78.5000, "estimated_amount": 2643, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 17513, "standard_charge_percentage": 78.5000, "estimated_amount": 17513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 18434.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1041.65, "standard_charge_percentage": 30.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2643.88, "standard_charge_percentage": 78.5000, "estimated_amount": 2643, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2951.34, "standard_charge_percentage": 85.0000, "estimated_amount": 2951, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 17881.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3472.16, "estimated_amount": 3472, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 20548.3, "standard_charge_percentage": 87.5000, "estimated_amount": 20548, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 19961.2, "standard_charge_percentage": 85.0000, "estimated_amount": 19961, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 23014.1, "standard_charge_percentage": 98.0000, "estimated_amount": 23014, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2589.36, "standard_charge_percentage": 78.5000, "estimated_amount": 2589, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 17881.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2698.39, "standard_charge_percentage": 78.5000, "estimated_amount": 2698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 17881.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2083.3, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2453.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2453, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2507.59, "standard_charge_percentage": 78.5000, "estimated_amount": 2507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3298.55, "standard_charge_percentage": 95.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3472.16, "standard_charge_percentage": 100.0000, "estimated_amount": 3472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2725.65, "standard_charge_percentage": 78.5000, "estimated_amount": 2725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 22309.6, "standard_charge_percentage": 95.0000, "estimated_amount": 22309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1388.86, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1388, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2643.88, "standard_charge_percentage": 78.5000, "estimated_amount": 2643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1909.69, "standard_charge_percentage": 55.0000, "estimated_amount": 1909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2725.65, "standard_charge_percentage": 78.5000, "estimated_amount": 2725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11741.9, "standard_charge_percentage": 50.0000, "estimated_amount": 11741, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3298.55, "standard_charge_percentage": 95.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3402.72, "standard_charge_percentage": 98.0000, "estimated_amount": 3402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2643.88, "standard_charge_percentage": 78.5000, "estimated_amount": 2643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 18787, "standard_charge_percentage": 80.0000, "estimated_amount": 18787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3472.16, "estimated_amount": 3472, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7045.14, "standard_charge_percentage": 30.0000, "estimated_amount": 7045, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 18250.4, "standard_charge_percentage": 78.5000, "estimated_amount": 18250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11741.9, "standard_charge_percentage": 50.0000, "estimated_amount": 11741, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 21135.4, "standard_charge_percentage": 90.0000, "estimated_amount": 21135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2777.73, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9299.58, "standard_charge_percentage": 39.6000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2604.12, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" }]}]} , { "description": "Dbrdmt eczinfected skin<10%", "code_information": [ { "code": "11000", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 581.02, "discounted_cash": 714,"minimum": 174.31,"maximum": 581.02,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 581.02, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 581.02, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 581.02, "standard_charge_percentage": 100.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 290.51, "standard_charge_percentage": 50.0000, "estimated_amount": 290, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 442.42, "standard_charge_percentage": 78.5000, "estimated_amount": 442, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 419.61, "standard_charge_percentage": 78.5000, "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 319.56, "standard_charge_percentage": 55.0000, "estimated_amount": 319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 290.51, "standard_charge_percentage": 50.0000, "estimated_amount": 290, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 581.02, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 522.92, "standard_charge_percentage": 90.0000, "estimated_amount": 522, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 290.51, "standard_charge_percentage": 50.0000, "estimated_amount": 290, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 230.08, "standard_charge_percentage": 39.6000, "estimated_amount": 230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 493.87, "standard_charge_percentage": 85.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 456.1, "standard_charge_percentage": 78.5000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 522.92, "standard_charge_percentage": 90.0000, "estimated_amount": 522, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 174.31, "standard_charge_percentage": 30.0000, "estimated_amount": 174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 442.42, "standard_charge_percentage": 78.5000, "estimated_amount": 442, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 442.42, "standard_charge_percentage": 78.5000, "estimated_amount": 442, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 348.61, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 456.1, "standard_charge_percentage": 78.5000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 232.41, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 493.87, "standard_charge_percentage": 85.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 581.02, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 435.76, "standard_charge_percentage": 75.0000, "estimated_amount": 435, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 522.92, "standard_charge_percentage": 90.0000, "estimated_amount": 522, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 569.4, "standard_charge_percentage": 98.0000, "estimated_amount": 569, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 551.97, "standard_charge_percentage": 95.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 451.54, "standard_charge_percentage": 78.5000, "estimated_amount": 451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 433.3, "standard_charge_percentage": 78.5000, "estimated_amount": 433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 442.42, "standard_charge_percentage": 78.5000, "estimated_amount": 442, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 456.1, "standard_charge_percentage": 78.5000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 508.39, "standard_charge_percentage": 87.5000, "estimated_amount": 508, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 433.3, "standard_charge_percentage": 78.5000, "estimated_amount": 433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 410.49, "standard_charge_percentage": 78.5000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 464.82, "standard_charge_percentage": 80.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 551.97, "standard_charge_percentage": 95.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 442.42, "standard_charge_percentage": 78.5000, "estimated_amount": 442, "methodology": "percent of total billed charges" }]}]} , { "description": "UNLISTED PROC NERVOUS SYSTEM", "code_information": [ { "code": "11001", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 215.32,"minimum": 64.6,"maximum": 215.32,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 163.96, "standard_charge_percentage": 78.5000, "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 160.57, "standard_charge_percentage": 78.5000, "estimated_amount": 160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 129.19, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 169.03, "standard_charge_percentage": 78.5000, "estimated_amount": 169, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 155.5, "standard_charge_percentage": 78.5000, "estimated_amount": 155, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 163.96, "standard_charge_percentage": 78.5000, "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 215.32, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 85.27, "standard_charge_percentage": 39.6000, "estimated_amount": 85, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 183.02, "standard_charge_percentage": 85.0000, "estimated_amount": 183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 64.6, "standard_charge_percentage": 30.0000, "estimated_amount": 64, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 183.02, "standard_charge_percentage": 85.0000, "estimated_amount": 183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 118.43, "standard_charge_percentage": 55.0000, "estimated_amount": 118, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 160.57, "standard_charge_percentage": 78.5000, "estimated_amount": 160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 167.34, "standard_charge_percentage": 78.5000, "estimated_amount": 167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 163.96, "standard_charge_percentage": 78.5000, "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 152.12, "standard_charge_percentage": 78.5000, "estimated_amount": 152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 161.49, "standard_charge_percentage": 75.0000, "estimated_amount": 161, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 193.79, "standard_charge_percentage": 90.0000, "estimated_amount": 193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 169.03, "standard_charge_percentage": 78.5000, "estimated_amount": 169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 215.32, "standard_charge_percentage": 100.0000, "estimated_amount": 215, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 169.03, "standard_charge_percentage": 78.5000, "estimated_amount": 169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 172.26, "standard_charge_percentage": 80.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 204.55, "standard_charge_percentage": 95.0000, "estimated_amount": 204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 163.96, "standard_charge_percentage": 78.5000, "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 215.32, "estimated_amount": 215, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 211.01, "standard_charge_percentage": 98.0000, "estimated_amount": 211, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 193.79, "standard_charge_percentage": 90.0000, "estimated_amount": 193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 86.13, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 86, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 188.41, "standard_charge_percentage": 87.5000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 204.55, "standard_charge_percentage": 95.0000, "estimated_amount": 204, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 107.66, "standard_charge_percentage": 50.0000, "estimated_amount": 107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 193.79, "standard_charge_percentage": 90.0000, "estimated_amount": 193, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 163.96, "standard_charge_percentage": 78.5000, "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 107.66, "standard_charge_percentage": 50.0000, "estimated_amount": 107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 107.66, "standard_charge_percentage": 50.0000, "estimated_amount": 107, "methodology": "percent of total billed charges" }]}]} , { "description": "CHEMICAL PLEURODESIS", "code_information": [ { "code": "11004", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2520.8,"minimum": 756.24,"maximum": 2520.8,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1260.4, "standard_charge_percentage": 50.0000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2394.76, "standard_charge_percentage": 95.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1260.4, "standard_charge_percentage": 50.0000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2268.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1386.44, "standard_charge_percentage": 55.0000, "estimated_amount": 1386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1978.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1978, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1820.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1820, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1780.95, "standard_charge_percentage": 78.5000, "estimated_amount": 1780, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2268.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1879.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2205.7, "standard_charge_percentage": 87.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 998.24, "standard_charge_percentage": 39.6000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2268.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1512.48, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1008.32, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1008, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2470.38, "standard_charge_percentage": 98.0000, "estimated_amount": 2470, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1959.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1978.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2142.68, "standard_charge_percentage": 85.0000, "estimated_amount": 2142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1879.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2394.76, "standard_charge_percentage": 95.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2520.8, "standard_charge_percentage": 100.0000, "estimated_amount": 2520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1978.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1978, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1890.6, "standard_charge_percentage": 75.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1260.4, "standard_charge_percentage": 50.0000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2142.68, "standard_charge_percentage": 85.0000, "estimated_amount": 2142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 756.24, "standard_charge_percentage": 30.0000, "estimated_amount": 756, "methodology": "percent of total billed charges" }]}]} , { "description": "FINE NEEDLE ASPIRATION", "code_information": [ { "code": "11005", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 535,"minimum": 160.5,"maximum": 535,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 386.38, "standard_charge_percentage": 78.5000, "estimated_amount": 386, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 454.75, "standard_charge_percentage": 85.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 508.25, "standard_charge_percentage": 95.0000, "estimated_amount": 508, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 214, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 214, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 294.25, "standard_charge_percentage": 55.0000, "estimated_amount": 294, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 535, "estimated_amount": 535, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 401.25, "standard_charge_percentage": 75.0000, "estimated_amount": 401, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 377.98, "standard_charge_percentage": 78.5000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 535, "estimated_amount": 535, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 321, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 321, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 508.25, "standard_charge_percentage": 95.0000, "estimated_amount": 508, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 398.98, "standard_charge_percentage": 78.5000, "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 481.5, "standard_charge_percentage": 90.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 454.75, "standard_charge_percentage": 85.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 267.5, "standard_charge_percentage": 50.0000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 419.98, "standard_charge_percentage": 78.5000, "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 160.5, "standard_charge_percentage": 30.0000, "estimated_amount": 160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 468.13, "standard_charge_percentage": 87.5000, "estimated_amount": 468, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 267.5, "standard_charge_percentage": 50.0000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 407.38, "standard_charge_percentage": 78.5000, "estimated_amount": 407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 398.98, "standard_charge_percentage": 78.5000, "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 407.38, "standard_charge_percentage": 78.5000, "estimated_amount": 407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 415.78, "standard_charge_percentage": 78.5000, "estimated_amount": 415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 407.38, "standard_charge_percentage": 78.5000, "estimated_amount": 407, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 267.5, "standard_charge_percentage": 50.0000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 419.98, "standard_charge_percentage": 78.5000, "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 211.86, "standard_charge_percentage": 39.6000, "estimated_amount": 211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 481.5, "standard_charge_percentage": 90.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 407.38, "standard_charge_percentage": 78.5000, "estimated_amount": 407, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 524.3, "standard_charge_percentage": 98.0000, "estimated_amount": 524, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 481.5, "standard_charge_percentage": 90.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 419.98, "standard_charge_percentage": 78.5000, "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 428, "standard_charge_percentage": 80.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 535, "standard_charge_percentage": 100.0000, "estimated_amount": 535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 407.38, "standard_charge_percentage": 78.5000, "estimated_amount": 407, "methodology": "percent of total billed charges" }]}]} , { "description": "LYSIS PENIL CIRCUMCISION", "code_information": [ { "code": "11006", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2520.8,"minimum": 756.24,"maximum": 2520.8,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2470.38, "standard_charge_percentage": 98.0000, "estimated_amount": 2470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1879.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1780.95, "standard_charge_percentage": 78.5000, "estimated_amount": 1780, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 756.24, "standard_charge_percentage": 30.0000, "estimated_amount": 756, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2268.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2394.76, "standard_charge_percentage": 95.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1879.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1890.6, "standard_charge_percentage": 75.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1959.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1978.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1978, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1260.4, "standard_charge_percentage": 50.0000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1260.4, "standard_charge_percentage": 50.0000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2142.68, "standard_charge_percentage": 85.0000, "estimated_amount": 2142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1978.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1008.32, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2268.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1512.48, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1512, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1820.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1820, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2520.8, "standard_charge_percentage": 100.0000, "estimated_amount": 2520, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 998.24, "standard_charge_percentage": 39.6000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2205.7, "standard_charge_percentage": 87.5000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2394.76, "standard_charge_percentage": 95.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1919.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2016.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2268.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1386.44, "standard_charge_percentage": 55.0000, "estimated_amount": 1386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2142.68, "standard_charge_percentage": 85.0000, "estimated_amount": 2142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1978.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1978, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1260.4, "standard_charge_percentage": 50.0000, "estimated_amount": 1260, "methodology": "percent of total billed charges" }]}]} , { "description": "REPAIR OF CIRCUMCISION", "code_information": [ { "code": "11008", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 411.25,"minimum": 123.38,"maximum": 411.25,"payers_information":[{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 313.15, "standard_charge_percentage": 78.5000, "estimated_amount": 313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 164.5, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 205.63, "standard_charge_percentage": 50.0000, "estimated_amount": 205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 322.83, "standard_charge_percentage": 78.5000, "estimated_amount": 322, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 313.15, "standard_charge_percentage": 78.5000, "estimated_amount": 313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 290.55, "standard_charge_percentage": 78.5000, "estimated_amount": 290, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 313.15, "standard_charge_percentage": 78.5000, "estimated_amount": 313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 313.15, "standard_charge_percentage": 78.5000, "estimated_amount": 313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 226.19, "standard_charge_percentage": 55.0000, "estimated_amount": 226, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 370.13, "standard_charge_percentage": 90.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 306.69, "standard_charge_percentage": 78.5000, "estimated_amount": 306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 359.84, "standard_charge_percentage": 87.5000, "estimated_amount": 359, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 162.85, "standard_charge_percentage": 39.6000, "estimated_amount": 162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 246.75, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 246, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 411.25, "standard_charge_percentage": 100.0000, "estimated_amount": 411, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 390.69, "standard_charge_percentage": 95.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 411.25, "estimated_amount": 411, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 205.63, "standard_charge_percentage": 50.0000, "estimated_amount": 205, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 370.13, "standard_charge_percentage": 90.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 349.56, "standard_charge_percentage": 85.0000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 390.69, "standard_charge_percentage": 95.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 370.13, "standard_charge_percentage": 90.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 123.38, "standard_charge_percentage": 30.0000, "estimated_amount": 123, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 349.56, "standard_charge_percentage": 85.0000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 319.6, "standard_charge_percentage": 78.5000, "estimated_amount": 319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 329, "standard_charge_percentage": 80.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 322.83, "standard_charge_percentage": 78.5000, "estimated_amount": 322, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 411.25, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 297, "standard_charge_percentage": 78.5000, "estimated_amount": 297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 313.15, "standard_charge_percentage": 78.5000, "estimated_amount": 313, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 403.02, "standard_charge_percentage": 98.0000, "estimated_amount": 403, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 205.63, "standard_charge_percentage": 50.0000, "estimated_amount": 205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 308.44, "standard_charge_percentage": 75.0000, "estimated_amount": 308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 322.83, "standard_charge_percentage": 78.5000, "estimated_amount": 322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 306.69, "standard_charge_percentage": 78.5000, "estimated_amount": 306, "methodology": "percent of total billed charges" }]}]} , { "description": "Debride Skin At Fx Site", "code_information": [ { "code": "11010", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19634.1, "discounted_cash": 821,"minimum": 243.24,"maximum": 19634.1,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14179.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14179, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 703.5, "standard_charge_percentage": 50.0000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16689, "standard_charge_percentage": 85.0000, "estimated_amount": 16688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1104.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1104, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1195.95, "standard_charge_percentage": 85.0000, "estimated_amount": 1195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14642.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1016.14, "standard_charge_percentage": 78.5000, "estimated_amount": 1016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1231.13, "standard_charge_percentage": 87.5000, "estimated_amount": 1231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1049.27, "standard_charge_percentage": 78.5000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18652.4, "standard_charge_percentage": 95.0000, "estimated_amount": 18652, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19241.4, "standard_charge_percentage": 98.0000, "estimated_amount": 19241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 562.8, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1407, "standard_charge_percentage": 100.0000, "estimated_amount": 1407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1071.36, "standard_charge_percentage": 78.5000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 994.05, "standard_charge_percentage": 78.5000, "estimated_amount": 994, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1104.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 773.85, "standard_charge_percentage": 55.0000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13871.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13871, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1378.86, "standard_charge_percentage": 98.0000, "estimated_amount": 1378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14725.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1104.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1055.25, "standard_charge_percentage": 75.0000, "estimated_amount": 1055, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 422.1, "standard_charge_percentage": 30.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10798.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 703.5, "standard_charge_percentage": 50.0000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1071.36, "standard_charge_percentage": 78.5000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7775.1, "standard_charge_percentage": 39.6000, "estimated_amount": 7775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1336.65, "standard_charge_percentage": 95.0000, "estimated_amount": 1336, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 703.5, "standard_charge_percentage": 50.0000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1266.3, "standard_charge_percentage": 90.0000, "estimated_amount": 1266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1071.36, "standard_charge_percentage": 78.5000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16689, "standard_charge_percentage": 85.0000, "estimated_amount": 16688, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18652.4, "standard_charge_percentage": 95.0000, "estimated_amount": 18652, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1195.95, "standard_charge_percentage": 85.0000, "estimated_amount": 1195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1093.45, "standard_charge_percentage": 78.5000, "estimated_amount": 1093, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 557.17, "standard_charge_percentage": 39.6000, "estimated_amount": 557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1071.36, "standard_charge_percentage": 78.5000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1336.65, "standard_charge_percentage": 95.0000, "estimated_amount": 1336, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1266.3, "standard_charge_percentage": 90.0000, "estimated_amount": 1266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15258.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 844.2, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1266.3, "standard_charge_percentage": 90.0000, "estimated_amount": 1266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5890.23, "standard_charge_percentage": 30.0000, "estimated_amount": 5890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14642.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17179.8, "standard_charge_percentage": 87.5000, "estimated_amount": 17179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1049.27, "standard_charge_percentage": 78.5000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19634.1, "standard_charge_percentage": 100.0000, "estimated_amount": 19634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1071.36, "standard_charge_percentage": 78.5000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1125.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11012", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12875.4, "discounted_cash": 3342,"minimum": 325.58,"maximum": 12875.4,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 9803.97, "standard_charge_percentage": 78.5000, "estimated_amount": 9803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 11266, "standard_charge_percentage": 87.5000, "estimated_amount": 11265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 10006.1, "standard_charge_percentage": 78.5000, "estimated_amount": 10006, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 9096.46, "standard_charge_percentage": 78.5000, "estimated_amount": 9096, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 9803.97, "standard_charge_percentage": 78.5000, "estimated_amount": 9803, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 6437.69, "standard_charge_percentage": 50.0000, "estimated_amount": 6437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 12231.6, "standard_charge_percentage": 95.0000, "estimated_amount": 12231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 10944.1, "standard_charge_percentage": 85.0000, "estimated_amount": 10944, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 7081.46, "standard_charge_percentage": 55.0000, "estimated_amount": 7081, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 12875.4, "standard_charge_percentage": 100.0000, "estimated_amount": 12875, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 6437.69, "standard_charge_percentage": 50.0000, "estimated_amount": 6437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 11587.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 10944.1, "standard_charge_percentage": 85.0000, "estimated_amount": 10944, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 10107.2, "standard_charge_percentage": 78.5000, "estimated_amount": 10107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 6437.69, "standard_charge_percentage": 50.0000, "estimated_amount": 6437, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 9298.61, "standard_charge_percentage": 78.5000, "estimated_amount": 9298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 9656.54, "standard_charge_percentage": 75.0000, "estimated_amount": 9656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 9601.82, "standard_charge_percentage": 78.5000, "estimated_amount": 9601, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 11587.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 9601.82, "standard_charge_percentage": 78.5000, "estimated_amount": 9601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 9803.97, "standard_charge_percentage": 78.5000, "estimated_amount": 9803, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 12231.6, "standard_charge_percentage": 95.0000, "estimated_amount": 12231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 10107.2, "standard_charge_percentage": 78.5000, "estimated_amount": 10107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 9803.97, "standard_charge_percentage": 78.5000, "estimated_amount": 9803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 12617.9, "standard_charge_percentage": 98.0000, "estimated_amount": 12617, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 9803.97, "standard_charge_percentage": 78.5000, "estimated_amount": 9803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 11587.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3862.62, "standard_charge_percentage": 30.0000, "estimated_amount": 3862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 10107.2, "standard_charge_percentage": 78.5000, "estimated_amount": 10107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 10300.3, "standard_charge_percentage": 80.0000, "estimated_amount": 10300, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 5098.65, "standard_charge_percentage": 39.6000, "estimated_amount": 5098, "methodology": "percent of total billed charges" }]}]} , { "description": "Dbrdmt subq tis 1st 20sqcm<", "code_information": [ { "code": "11042", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20868.5, "discounted_cash": 466,"minimum": 243.24,"maximum": 20868.5,"payers_information":[{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 15651.4, "standard_charge_percentage": 75.0000, "estimated_amount": 15651, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15890.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6260.55, "standard_charge_percentage": 30.0000, "estimated_amount": 6260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 17738.2, "standard_charge_percentage": 85.0000, "estimated_amount": 17738, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 17738.2, "standard_charge_percentage": 85.0000, "estimated_amount": 17738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 16381.8, "standard_charge_percentage": 78.5000, "estimated_amount": 16381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15890.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15890, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 20868.5, "standard_charge_percentage": 100.0000, "estimated_amount": 20868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 15562.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 18781.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10434.3, "standard_charge_percentage": 50.0000, "estimated_amount": 10434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 16381.8, "standard_charge_percentage": 78.5000, "estimated_amount": 16381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 15562.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 16218, "standard_charge_percentage": 78.5000, "estimated_amount": 16217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15890.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8263.93, "standard_charge_percentage": 39.6000, "estimated_amount": 8263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10434.3, "standard_charge_percentage": 50.0000, "estimated_amount": 10434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 15071.2, "standard_charge_percentage": 78.5000, "estimated_amount": 15071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10434.3, "standard_charge_percentage": 50.0000, "estimated_amount": 10434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 18259.9, "standard_charge_percentage": 87.5000, "estimated_amount": 18259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15890.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 19825.1, "standard_charge_percentage": 95.0000, "estimated_amount": 19825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 16694.8, "standard_charge_percentage": 80.0000, "estimated_amount": 16694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16381.8, "standard_charge_percentage": 78.5000, "estimated_amount": 16381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15890.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15890, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 18781.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18781, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 20451.1, "standard_charge_percentage": 98.0000, "estimated_amount": 20451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 18781.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 19825.1, "standard_charge_percentage": 95.0000, "estimated_amount": 19825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11477.7, "standard_charge_percentage": 55.0000, "estimated_amount": 11477, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14743.6, "standard_charge_percentage": 78.5000, "estimated_amount": 14743, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" }]}]} , { "description": "I&D ABSCESS DEEP LEG/ANKLE", "code_information": [ { "code": "11043", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2645.85, "discounted_cash": 714,"minimum": 325.58,"maximum": 19729.1,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2315.12, "standard_charge_percentage": 87.5000, "estimated_amount": 2315, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7812.72, "standard_charge_percentage": 39.6000, "estimated_amount": 7812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1455.22, "standard_charge_percentage": 55.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17756.2, "standard_charge_percentage": 90.0000, "estimated_amount": 17756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15487.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15487.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16769.7, "standard_charge_percentage": 85.0000, "estimated_amount": 16769, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1973.14, "standard_charge_percentage": 78.5000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15487.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9864.55, "standard_charge_percentage": 50.0000, "estimated_amount": 9864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15022.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15022, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2248.97, "standard_charge_percentage": 85.0000, "estimated_amount": 2248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13938.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13938, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9864.55, "standard_charge_percentage": 50.0000, "estimated_amount": 9864, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15022.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15022, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17756.2, "standard_charge_percentage": 90.0000, "estimated_amount": 17756, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2592.93, "standard_charge_percentage": 98.0000, "estimated_amount": 2592, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15022.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15022, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17756.2, "standard_charge_percentage": 90.0000, "estimated_amount": 17756, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17263, "standard_charge_percentage": 87.5000, "estimated_amount": 17262, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14248.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15332.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15022.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15022, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1587.51, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1587, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1869.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18742.6, "standard_charge_percentage": 95.0000, "estimated_amount": 18742, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16769.7, "standard_charge_percentage": 85.0000, "estimated_amount": 16769, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1058.34, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1973.14, "standard_charge_percentage": 78.5000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19334.5, "standard_charge_percentage": 98.0000, "estimated_amount": 19334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2248.97, "standard_charge_percentage": 85.0000, "estimated_amount": 2248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2513.56, "standard_charge_percentage": 95.0000, "estimated_amount": 2513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 793.75, "standard_charge_percentage": 30.0000, "estimated_amount": 793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19729.1, "standard_charge_percentage": 100.0000, "estimated_amount": 19729, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14713, "standard_charge_percentage": 78.5000, "estimated_amount": 14712, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2645.85, "standard_charge_percentage": 100.0000, "estimated_amount": 2645, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15022.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15022, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14713, "standard_charge_percentage": 78.5000, "estimated_amount": 14712, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1984.39, "standard_charge_percentage": 75.0000, "estimated_amount": 1984, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2513.56, "standard_charge_percentage": 95.0000, "estimated_amount": 2513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9864.55, "standard_charge_percentage": 50.0000, "estimated_amount": 9864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10851, "standard_charge_percentage": 55.0000, "estimated_amount": 10851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14796.8, "standard_charge_percentage": 75.0000, "estimated_amount": 14796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2056.22, "standard_charge_percentage": 78.5000, "estimated_amount": 2056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18742.6, "standard_charge_percentage": 95.0000, "estimated_amount": 18742, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1047.76, "standard_charge_percentage": 39.6000, "estimated_amount": 1047, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15783.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15783, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1910.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1910, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5918.73, "standard_charge_percentage": 30.0000, "estimated_amount": 5918, "methodology": "percent of total billed charges" }]}]} , { "description": "INS PICC LINE WO IMG GUID 5YR+", "code_information": [ { "code": "11044", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6830.25, "discounted_cash": 1892,"minimum": 325.58,"maximum": 21615.5,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 21615.5, "standard_charge_percentage": 100.0000, "estimated_amount": 21615, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2049.07, "standard_charge_percentage": 30.0000, "estimated_amount": 2049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 16459.1, "standard_charge_percentage": 78.5000, "estimated_amount": 16459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3756.64, "standard_charge_percentage": 55.0000, "estimated_amount": 3756, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 20534.7, "standard_charge_percentage": 95.0000, "estimated_amount": 20534, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2704.78, "standard_charge_percentage": 39.6000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 16211.6, "standard_charge_percentage": 75.0000, "estimated_amount": 16211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16968.2, "standard_charge_percentage": 78.5000, "estimated_amount": 16968, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10807.8, "standard_charge_percentage": 50.0000, "estimated_amount": 10807, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 19454, "standard_charge_percentage": 90.0000, "estimated_amount": 19453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5976.47, "standard_charge_percentage": 87.5000, "estimated_amount": 5976, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 19454, "standard_charge_percentage": 90.0000, "estimated_amount": 19453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11888.5, "standard_charge_percentage": 55.0000, "estimated_amount": 11888, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10807.8, "standard_charge_percentage": 50.0000, "estimated_amount": 10807, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 18373.2, "standard_charge_percentage": 85.0000, "estimated_amount": 18373, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 19454, "standard_charge_percentage": 90.0000, "estimated_amount": 19453, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 18913.6, "standard_charge_percentage": 87.5000, "estimated_amount": 18913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 15271.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15271, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2732.1, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2732, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 16459.1, "standard_charge_percentage": 78.5000, "estimated_amount": 16459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4825.57, "standard_charge_percentage": 78.5000, "estimated_amount": 4825, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 15610.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 16459.1, "standard_charge_percentage": 78.5000, "estimated_amount": 16459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6484.65, "standard_charge_percentage": 30.0000, "estimated_amount": 6484, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 16798.5, "standard_charge_percentage": 78.5000, "estimated_amount": 16798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6830.25, "standard_charge_percentage": 100.0000, "estimated_amount": 6830, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 18373.2, "standard_charge_percentage": 85.0000, "estimated_amount": 18373, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 16459.1, "standard_charge_percentage": 78.5000, "estimated_amount": 16459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 16968.2, "standard_charge_percentage": 78.5000, "estimated_amount": 16968, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4932.81, "standard_charge_percentage": 78.5000, "estimated_amount": 4932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 21183.2, "standard_charge_percentage": 98.0000, "estimated_amount": 21183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 20534.7, "standard_charge_percentage": 95.0000, "estimated_amount": 20534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5308.13, "standard_charge_percentage": 78.5000, "estimated_amount": 5308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 17292.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 16119.8, "standard_charge_percentage": 78.5000, "estimated_amount": 16119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5122.69, "standard_charge_percentage": 75.0000, "estimated_amount": 5122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 16968.2, "standard_charge_percentage": 78.5000, "estimated_amount": 16968, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8559.74, "standard_charge_percentage": 39.6000, "estimated_amount": 8559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 16459.1, "standard_charge_percentage": 78.5000, "estimated_amount": 16459, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6693.65, "standard_charge_percentage": 98.0000, "estimated_amount": 6693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 16119.8, "standard_charge_percentage": 78.5000, "estimated_amount": 16119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10807.8, "standard_charge_percentage": 50.0000, "estimated_amount": 10807, "methodology": "percent of total billed charges" }]}]} , { "description": "DECLOT PORT W/ THROMB AGNT", "code_information": [ { "code": "11045", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1387.13,"minimum": 416.14,"maximum": 1387.13,"payers_information":[{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 762.92, "standard_charge_percentage": 55.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1056.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1317.77, "standard_charge_percentage": 95.0000, "estimated_amount": 1317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1248.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1056.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1056.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1088.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1248.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1248, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1179.06, "standard_charge_percentage": 85.0000, "estimated_amount": 1179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 693.57, "standard_charge_percentage": 50.0000, "estimated_amount": 693, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1213.74, "standard_charge_percentage": 87.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1078.01, "standard_charge_percentage": 78.5000, "estimated_amount": 1078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1040.35, "standard_charge_percentage": 75.0000, "estimated_amount": 1040, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1317.77, "standard_charge_percentage": 95.0000, "estimated_amount": 1317, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 693.57, "standard_charge_percentage": 50.0000, "estimated_amount": 693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1034.45, "standard_charge_percentage": 78.5000, "estimated_amount": 1034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1056.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1056.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1088.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1034.45, "standard_charge_percentage": 78.5000, "estimated_amount": 1034, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 416.14, "standard_charge_percentage": 30.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 693.57, "standard_charge_percentage": 50.0000, "estimated_amount": 693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 554.85, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 554, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1248.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 832.28, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 832, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 549.3, "standard_charge_percentage": 39.6000, "estimated_amount": 549, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1088.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1179.06, "standard_charge_percentage": 85.0000, "estimated_amount": 1179, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1359.39, "standard_charge_percentage": 98.0000, "estimated_amount": 1359, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 980.01, "standard_charge_percentage": 78.5000, "estimated_amount": 980, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1387.13, "standard_charge_percentage": 100.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1109.7, "standard_charge_percentage": 80.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1001.79, "standard_charge_percentage": 78.5000, "estimated_amount": 1001, "methodology": "percent of total billed charges" }]}]} , { "description": "RPLC TUNNELED CV CATH W/PORT", "code_information": [ { "code": "11046", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 868.9,"minimum": 260.67,"maximum": 868.9,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 825.46, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 661.62, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 868.9, "standard_charge_percentage": 100.0000, "estimated_amount": 868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 825.46, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 675.27, "standard_charge_percentage": 78.5000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 434.45, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 434.45, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 682.09, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 782.01, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 682.09, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 613.88, "standard_charge_percentage": 78.5000, "estimated_amount": 613, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 651.67, "standard_charge_percentage": 75.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 782.01, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 760.29, "standard_charge_percentage": 87.5000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 627.52, "standard_charge_percentage": 78.5000, "estimated_amount": 627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 661.62, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 647.98, "standard_charge_percentage": 78.5000, "estimated_amount": 647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 434.45, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 260.67, "standard_charge_percentage": 30.0000, "estimated_amount": 260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 477.89, "standard_charge_percentage": 55.0000, "estimated_amount": 477, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 647.98, "standard_charge_percentage": 78.5000, "estimated_amount": 647, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 851.52, "standard_charge_percentage": 98.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 695.12, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 661.62, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 521.34, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 661.62, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 344.08, "standard_charge_percentage": 39.6000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 738.57, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 661.62, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 782.01, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 868.9, "estimated_amount": 868, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 347.56, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 682.09, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 738.57, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" }]}]} , { "description": "COMPLETE RPL PICC WO PORT RS&I", "code_information": [ { "code": "11047", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2070.5,"minimum": 511,"maximum": 2070.5,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1863.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1863, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1625.34, "standard_charge_percentage": 78.5000, "estimated_amount": 1625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1544.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 819.92, "standard_charge_percentage": 39.6000, "estimated_amount": 819, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1576.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1576, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1138.78, "standard_charge_percentage": 55.0000, "estimated_amount": 1138, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2029.09, "standard_charge_percentage": 98.0000, "estimated_amount": 2029, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1625.34, "standard_charge_percentage": 78.5000, "estimated_amount": 1625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 828.2, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 828, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1576.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1576, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1035.25, "standard_charge_percentage": 50.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1552.88, "standard_charge_percentage": 75.0000, "estimated_amount": 1552, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1863.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1863, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2070.5, "standard_charge_percentage": 100.0000, "estimated_amount": 2070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1035.25, "standard_charge_percentage": 50.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1576.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1576, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1242.3, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1242, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1966.97, "standard_charge_percentage": 95.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1966.97, "standard_charge_percentage": 95.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1759.92, "standard_charge_percentage": 85.0000, "estimated_amount": 1759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1544.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1863.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1863, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1625.34, "standard_charge_percentage": 78.5000, "estimated_amount": 1625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1462.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1811.69, "standard_charge_percentage": 87.5000, "estimated_amount": 1811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1759.92, "standard_charge_percentage": 85.0000, "estimated_amount": 1759, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1609.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1576.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1576, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 621.15, "standard_charge_percentage": 30.0000, "estimated_amount": 621, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1576.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1576, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1495.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1035.25, "standard_charge_percentage": 50.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1656, "methodology": "percent of total billed charges" }]}]} , { "description": "COMPLETE RPL PICC W/ PORT RS&I", "code_information": [ { "code": "11055", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 843.4, "discounted_cash": 232,"minimum": 169.58,"maximum": 843.4,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 506.04, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 506, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 595.86, "standard_charge_percentage": 78.5000, "estimated_amount": 595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 655.45, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 632.55, "standard_charge_percentage": 75.0000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 253.02, "standard_charge_percentage": 30.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 716.89, "standard_charge_percentage": 85.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 463.87, "standard_charge_percentage": 55.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 609.1, "standard_charge_percentage": 78.5000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 801.23, "standard_charge_percentage": 95.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 716.89, "standard_charge_percentage": 85.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 337.36, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 826.53, "standard_charge_percentage": 98.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 628.97, "standard_charge_percentage": 78.5000, "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 801.23, "standard_charge_percentage": 95.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 333.99, "standard_charge_percentage": 39.6000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 628.97, "standard_charge_percentage": 78.5000, "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 843.4, "standard_charge_percentage": 100.0000, "estimated_amount": 843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 737.98, "standard_charge_percentage": 87.5000, "estimated_amount": 737, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" }]}]} , { "description": "PLC TUBE NASOGAST FLUOR GUIDE", "code_information": [ { "code": "11056", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 917.79, "discounted_cash": 232,"minimum": 169.58,"maximum": 917.79,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 720.47, "standard_charge_percentage": 78.5000, "estimated_amount": 720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 698.85, "standard_charge_percentage": 78.5000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 917.79, "standard_charge_percentage": 100.0000, "estimated_amount": 917, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 662.83, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 458.89, "standard_charge_percentage": 50.0000, "estimated_amount": 458, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 698.85, "standard_charge_percentage": 78.5000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 698.85, "standard_charge_percentage": 78.5000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 684.44, "standard_charge_percentage": 78.5000, "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 720.47, "standard_charge_percentage": 78.5000, "estimated_amount": 720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 871.9, "standard_charge_percentage": 95.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 458.89, "standard_charge_percentage": 50.0000, "estimated_amount": 458, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 688.34, "standard_charge_percentage": 75.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 713.26, "standard_charge_percentage": 78.5000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 363.44, "standard_charge_percentage": 39.6000, "estimated_amount": 363, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 871.9, "standard_charge_percentage": 95.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 367.12, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 367, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 458.89, "standard_charge_percentage": 50.0000, "estimated_amount": 458, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 780.12, "standard_charge_percentage": 85.0000, "estimated_amount": 780, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 780.12, "standard_charge_percentage": 85.0000, "estimated_amount": 780, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 684.44, "standard_charge_percentage": 78.5000, "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 698.85, "standard_charge_percentage": 78.5000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 720.47, "standard_charge_percentage": 78.5000, "estimated_amount": 720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 899.43, "standard_charge_percentage": 98.0000, "estimated_amount": 899, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 803.07, "standard_charge_percentage": 87.5000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 550.67, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 504.78, "standard_charge_percentage": 55.0000, "estimated_amount": 504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 698.85, "standard_charge_percentage": 78.5000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 826.01, "standard_charge_percentage": 90.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 826.01, "standard_charge_percentage": 90.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 734.23, "standard_charge_percentage": 80.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 648.42, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 826.01, "standard_charge_percentage": 90.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 275.34, "standard_charge_percentage": 30.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" }]}]} , { "description": "Parngcutg b9 hyprkr les >4", "code_information": [ { "code": "11057", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 354.6, "discounted_cash": 232,"minimum": 106.38,"maximum": 354.6,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 354.6, "estimated_amount": 354, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 310.28, "standard_charge_percentage": 87.5000, "estimated_amount": 310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 106.38, "standard_charge_percentage": 30.0000, "estimated_amount": 106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 177.3, "standard_charge_percentage": 50.0000, "estimated_amount": 177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 336.87, "standard_charge_percentage": 95.0000, "estimated_amount": 336, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 354.6, "standard_charge_percentage": 100.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 270.01, "standard_charge_percentage": 78.5000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 264.44, "standard_charge_percentage": 78.5000, "estimated_amount": 264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 177.3, "standard_charge_percentage": 50.0000, "estimated_amount": 177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 270.01, "standard_charge_percentage": 78.5000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 177.3, "standard_charge_percentage": 50.0000, "estimated_amount": 177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 336.87, "standard_charge_percentage": 95.0000, "estimated_amount": 336, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 270.01, "standard_charge_percentage": 78.5000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 270.01, "standard_charge_percentage": 78.5000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 250.52, "standard_charge_percentage": 78.5000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 278.36, "standard_charge_percentage": 78.5000, "estimated_amount": 278, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 270.01, "standard_charge_percentage": 78.5000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 265.95, "standard_charge_percentage": 75.0000, "estimated_amount": 265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 264.44, "standard_charge_percentage": 78.5000, "estimated_amount": 264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 278.36, "standard_charge_percentage": 78.5000, "estimated_amount": 278, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 275.58, "standard_charge_percentage": 78.5000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 347.51, "standard_charge_percentage": 98.0000, "estimated_amount": 347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 301.41, "standard_charge_percentage": 85.0000, "estimated_amount": 301, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 354.6, "estimated_amount": 354, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 319.14, "standard_charge_percentage": 90.0000, "estimated_amount": 319, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 301.41, "standard_charge_percentage": 85.0000, "estimated_amount": 301, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 212.76, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 319.14, "standard_charge_percentage": 90.0000, "estimated_amount": 319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 278.36, "standard_charge_percentage": 78.5000, "estimated_amount": 278, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 319.14, "standard_charge_percentage": 90.0000, "estimated_amount": 319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 140.42, "standard_charge_percentage": 39.6000, "estimated_amount": 140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 195.03, "standard_charge_percentage": 55.0000, "estimated_amount": 195, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 256.09, "standard_charge_percentage": 78.5000, "estimated_amount": 256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 141.84, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 141, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 283.68, "standard_charge_percentage": 80.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Tangential Biopsy Skin Single Lesion", "code_information": [ { "code": "11102", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 882.25, "discounted_cash": 232,"minimum": 169.58,"maximum": 882.25,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 349.37, "standard_charge_percentage": 39.6000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 657.94, "standard_charge_percentage": 78.5000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 838.14, "standard_charge_percentage": 95.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 794.02, "standard_charge_percentage": 90.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 771.97, "standard_charge_percentage": 87.5000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 692.57, "standard_charge_percentage": 78.5000, "estimated_amount": 692, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 637.16, "standard_charge_percentage": 78.5000, "estimated_amount": 637, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 838.14, "standard_charge_percentage": 95.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 692.57, "standard_charge_percentage": 78.5000, "estimated_amount": 692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 685.64, "standard_charge_percentage": 78.5000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 661.69, "standard_charge_percentage": 75.0000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 657.94, "standard_charge_percentage": 78.5000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 529.35, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 864.61, "standard_charge_percentage": 98.0000, "estimated_amount": 864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 485.24, "standard_charge_percentage": 55.0000, "estimated_amount": 485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 749.91, "standard_charge_percentage": 85.0000, "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 441.13, "standard_charge_percentage": 50.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 441.13, "standard_charge_percentage": 50.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 264.68, "standard_charge_percentage": 30.0000, "estimated_amount": 264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 352.9, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 749.91, "standard_charge_percentage": 85.0000, "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 794.02, "standard_charge_percentage": 90.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 692.57, "standard_charge_percentage": 78.5000, "estimated_amount": 692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 441.13, "standard_charge_percentage": 50.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 882.25, "standard_charge_percentage": 100.0000, "estimated_amount": 882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 794.02, "standard_charge_percentage": 90.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 623.31, "standard_charge_percentage": 78.5000, "estimated_amount": 623, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Tangential Biopsy Skin Ea Sep/Additional Lesion", "code_information": [ { "code": "11103", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 500,"minimum": 150,"maximum": 500,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 216.49, "estimated_amount": 216, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 437.5, "standard_charge_percentage": 87.5000, "estimated_amount": 437, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 150, "standard_charge_percentage": 30.0000, "estimated_amount": 150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 375, "standard_charge_percentage": 75.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 490, "standard_charge_percentage": 98.0000, "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 500, "standard_charge_percentage": 100.0000, "estimated_amount": 500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 353.25, "standard_charge_percentage": 78.5000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 388.57, "standard_charge_percentage": 78.5000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 361.1, "standard_charge_percentage": 78.5000, "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 216.49, "estimated_amount": 216, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 275, "standard_charge_percentage": 55.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 198, "standard_charge_percentage": 39.6000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 300, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 200, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" }]}]} , { "description": "Punch bx skin single lesion", "code_information": [ { "code": "11104", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 882.25, "discounted_cash": 466,"minimum": 243.24,"maximum": 882.25,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 441.13, "standard_charge_percentage": 50.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 441.13, "standard_charge_percentage": 50.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 794.02, "standard_charge_percentage": 90.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 794.02, "standard_charge_percentage": 90.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 794.02, "standard_charge_percentage": 90.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 692.57, "standard_charge_percentage": 78.5000, "estimated_amount": 692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 441.13, "standard_charge_percentage": 50.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 657.94, "standard_charge_percentage": 78.5000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 657.94, "standard_charge_percentage": 78.5000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 671.79, "standard_charge_percentage": 78.5000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 349.37, "standard_charge_percentage": 39.6000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 529.35, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 692.57, "standard_charge_percentage": 78.5000, "estimated_amount": 692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 864.61, "standard_charge_percentage": 98.0000, "estimated_amount": 864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 838.14, "standard_charge_percentage": 95.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 771.97, "standard_charge_percentage": 87.5000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 838.14, "standard_charge_percentage": 95.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 352.9, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 623.31, "standard_charge_percentage": 78.5000, "estimated_amount": 623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 882.25, "standard_charge_percentage": 100.0000, "estimated_amount": 882, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 685.64, "standard_charge_percentage": 78.5000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 692.57, "standard_charge_percentage": 78.5000, "estimated_amount": 692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 264.68, "standard_charge_percentage": 30.0000, "estimated_amount": 264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 485.24, "standard_charge_percentage": 55.0000, "estimated_amount": 485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 749.91, "standard_charge_percentage": 85.0000, "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 637.16, "standard_charge_percentage": 78.5000, "estimated_amount": 637, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 749.91, "standard_charge_percentage": 85.0000, "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 661.69, "standard_charge_percentage": 75.0000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 705.8, "standard_charge_percentage": 80.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Punch Biopsy Skin Ea Sep/Additional Lesion", "code_information": [ { "code": "11105", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 500,"minimum": 150,"maximum": 500,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 375, "standard_charge_percentage": 75.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 372.88, "standard_charge_percentage": 78.5000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 216.49, "estimated_amount": 216, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 437.5, "standard_charge_percentage": 87.5000, "estimated_amount": 437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 388.57, "standard_charge_percentage": 78.5000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 475, "standard_charge_percentage": 95.0000, "estimated_amount": 475, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 300, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 450, "standard_charge_percentage": 90.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 353.25, "standard_charge_percentage": 78.5000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 275, "standard_charge_percentage": 55.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 380.72, "standard_charge_percentage": 78.5000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 200, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 500, "standard_charge_percentage": 100.0000, "estimated_amount": 500, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 490, "standard_charge_percentage": 98.0000, "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 198, "standard_charge_percentage": 39.6000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 392.5, "standard_charge_percentage": 78.5000, "estimated_amount": 392, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 250, "standard_charge_percentage": 50.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 150, "standard_charge_percentage": 30.0000, "estimated_amount": 150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 425, "standard_charge_percentage": 85.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 361.1, "standard_charge_percentage": 78.5000, "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 500, "estimated_amount": 500, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 216.49, "estimated_amount": 216, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 400, "standard_charge_percentage": 80.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Incisional Biopsy Skin Single Lesion", "code_information": [ { "code": "11106", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1570.4, "discounted_cash": 714,"minimum": 243.24,"maximum": 1570.4,"payers_information":[{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 863.72, "standard_charge_percentage": 55.0000, "estimated_amount": 863, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1374.1, "standard_charge_percentage": 87.5000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1134.14, "standard_charge_percentage": 78.5000, "estimated_amount": 1134, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1195.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1195, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1413.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1171.13, "standard_charge_percentage": 78.5000, "estimated_amount": 1171, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1171.13, "standard_charge_percentage": 78.5000, "estimated_amount": 1171, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1570.4, "standard_charge_percentage": 100.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 942.24, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 942, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1195.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1195.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1232.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1334.84, "standard_charge_percentage": 85.0000, "estimated_amount": 1334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1232.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1413.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1177.8, "standard_charge_percentage": 75.0000, "estimated_amount": 1177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1334.84, "standard_charge_percentage": 85.0000, "estimated_amount": 1334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1109.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1491.88, "standard_charge_percentage": 95.0000, "estimated_amount": 1491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 621.88, "standard_charge_percentage": 39.6000, "estimated_amount": 621, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 471.12, "standard_charge_percentage": 30.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 785.2, "standard_charge_percentage": 50.0000, "estimated_amount": 785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1220.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 785.2, "standard_charge_percentage": 50.0000, "estimated_amount": 785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1413.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1232.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1491.88, "standard_charge_percentage": 95.0000, "estimated_amount": 1491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1195.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1538.99, "standard_charge_percentage": 98.0000, "estimated_amount": 1538, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 785.2, "standard_charge_percentage": 50.0000, "estimated_amount": 785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1195.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 628.16, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1256.32, "standard_charge_percentage": 80.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" }]}]} , { "description": "EXC BEN LES TRNK ARM 1.1-2.0CM", "code_information": [ { "code": "11200", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 351.53, "discounted_cash": 232,"minimum": 105.46,"maximum": 351.53,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 275.95, "standard_charge_percentage": 78.5000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 273.19, "standard_charge_percentage": 78.5000, "estimated_amount": 273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 193.34, "standard_charge_percentage": 55.0000, "estimated_amount": 193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 267.67, "standard_charge_percentage": 78.5000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 248.36, "standard_charge_percentage": 78.5000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 267.67, "standard_charge_percentage": 78.5000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 275.95, "standard_charge_percentage": 78.5000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 139.21, "standard_charge_percentage": 39.6000, "estimated_amount": 139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 298.8, "standard_charge_percentage": 85.0000, "estimated_amount": 298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 210.92, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 298.8, "standard_charge_percentage": 85.0000, "estimated_amount": 298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 275.95, "standard_charge_percentage": 78.5000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 333.95, "standard_charge_percentage": 95.0000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 267.67, "standard_charge_percentage": 78.5000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 351.53, "estimated_amount": 351, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 253.87, "standard_charge_percentage": 78.5000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 316.38, "standard_charge_percentage": 90.0000, "estimated_amount": 316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 175.76, "standard_charge_percentage": 50.0000, "estimated_amount": 175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 267.67, "standard_charge_percentage": 78.5000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 351.53, "estimated_amount": 351, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 140.61, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 105.46, "standard_charge_percentage": 30.0000, "estimated_amount": 105, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 316.38, "standard_charge_percentage": 90.0000, "estimated_amount": 316, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 307.59, "standard_charge_percentage": 87.5000, "estimated_amount": 307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 316.38, "standard_charge_percentage": 90.0000, "estimated_amount": 316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 333.95, "standard_charge_percentage": 95.0000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 344.5, "standard_charge_percentage": 98.0000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 262.15, "standard_charge_percentage": 78.5000, "estimated_amount": 262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 281.22, "standard_charge_percentage": 80.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 267.67, "standard_charge_percentage": 78.5000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 175.76, "standard_charge_percentage": 50.0000, "estimated_amount": 175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 262.15, "standard_charge_percentage": 78.5000, "estimated_amount": 262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 351.53, "standard_charge_percentage": 100.0000, "estimated_amount": 351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 263.65, "standard_charge_percentage": 75.0000, "estimated_amount": 263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 175.76, "standard_charge_percentage": 50.0000, "estimated_amount": 175, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11301", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 35329.7, "discounted_cash": 232,"minimum": 169.58,"maximum": 35329.7,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 25515.1, "standard_charge_percentage": 78.5000, "estimated_amount": 25515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 27733.8, "standard_charge_percentage": 78.5000, "estimated_amount": 27733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10598.9, "standard_charge_percentage": 30.0000, "estimated_amount": 10598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 26347.1, "standard_charge_percentage": 78.5000, "estimated_amount": 26347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 26901.8, "standard_charge_percentage": 78.5000, "estimated_amount": 26901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 19431.3, "standard_charge_percentage": 55.0000, "estimated_amount": 19431, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 26901.8, "standard_charge_percentage": 78.5000, "estimated_amount": 26901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 31796.7, "standard_charge_percentage": 90.0000, "estimated_amount": 31796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 31796.7, "standard_charge_percentage": 90.0000, "estimated_amount": 31796, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 31796.7, "standard_charge_percentage": 90.0000, "estimated_amount": 31796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 27456.4, "standard_charge_percentage": 78.5000, "estimated_amount": 27456, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 17664.8, "standard_charge_percentage": 50.0000, "estimated_amount": 17664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 13990.5, "standard_charge_percentage": 39.6000, "estimated_amount": 13990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 27733.8, "standard_charge_percentage": 78.5000, "estimated_amount": 27733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 27733.8, "standard_charge_percentage": 78.5000, "estimated_amount": 27733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 26497.2, "standard_charge_percentage": 75.0000, "estimated_amount": 26497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 26347.1, "standard_charge_percentage": 78.5000, "estimated_amount": 26347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 24960.4, "standard_charge_percentage": 78.5000, "estimated_amount": 24960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 30030.2, "standard_charge_percentage": 85.0000, "estimated_amount": 30030, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 34623.1, "standard_charge_percentage": 98.0000, "estimated_amount": 34623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 26901.8, "standard_charge_percentage": 78.5000, "estimated_amount": 26901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 33563.2, "standard_charge_percentage": 95.0000, "estimated_amount": 33563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 26901.8, "standard_charge_percentage": 78.5000, "estimated_amount": 26901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 30913.4, "standard_charge_percentage": 87.5000, "estimated_amount": 30913, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 30030.2, "standard_charge_percentage": 85.0000, "estimated_amount": 30030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 17664.8, "standard_charge_percentage": 50.0000, "estimated_amount": 17664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 35329.7, "standard_charge_percentage": 100.0000, "estimated_amount": 35329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 26901.8, "standard_charge_percentage": 78.5000, "estimated_amount": 26901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 17664.8, "standard_charge_percentage": 50.0000, "estimated_amount": 17664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 33563.2, "standard_charge_percentage": 95.0000, "estimated_amount": 33563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 28263.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28263, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc tr-ext b9+marg 0.5 cm<", "code_information": [ { "code": "11400", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19735.5, "discounted_cash": 821,"minimum": 243.24,"maximum": 19735.5,"payers_information":[{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16775.2, "standard_charge_percentage": 85.0000, "estimated_amount": 16775, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13943.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13943, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19735.5, "standard_charge_percentage": 100.0000, "estimated_amount": 19735, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18748.7, "standard_charge_percentage": 95.0000, "estimated_amount": 18748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15337.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17268.6, "standard_charge_percentage": 87.5000, "estimated_amount": 17268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14717.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18748.7, "standard_charge_percentage": 95.0000, "estimated_amount": 18748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10854.5, "standard_charge_percentage": 55.0000, "estimated_amount": 10854, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14253, "standard_charge_percentage": 78.5000, "estimated_amount": 14252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16775.2, "standard_charge_percentage": 85.0000, "estimated_amount": 16775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19340.8, "standard_charge_percentage": 98.0000, "estimated_amount": 19340, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7815.26, "standard_charge_percentage": 39.6000, "estimated_amount": 7815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5920.65, "standard_charge_percentage": 30.0000, "estimated_amount": 5920, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14717.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14801.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" }]}]} , { "description": "Hc Exc B9 Lesion Mrgn Xcp Sk Tg T/A/L 1.1-2.0 Cm", "code_information": [ { "code": "11402", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1605.95, "discounted_cash": 821,"minimum": 243.24,"maximum": 1605.95,"payers_information":[{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1134.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 883.27, "standard_charge_percentage": 55.0000, "estimated_amount": 883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 802.98, "standard_charge_percentage": 50.0000, "estimated_amount": 802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1365.06, "standard_charge_percentage": 85.0000, "estimated_amount": 1365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1525.65, "standard_charge_percentage": 95.0000, "estimated_amount": 1525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1573.83, "standard_charge_percentage": 98.0000, "estimated_amount": 1573, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1365.06, "standard_charge_percentage": 85.0000, "estimated_amount": 1365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1525.65, "standard_charge_percentage": 95.0000, "estimated_amount": 1525, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1260.67, "standard_charge_percentage": 78.5000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1605.95, "standard_charge_percentage": 100.0000, "estimated_amount": 1605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 481.79, "standard_charge_percentage": 30.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1260.67, "standard_charge_percentage": 78.5000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1405.21, "standard_charge_percentage": 87.5000, "estimated_amount": 1405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 642.38, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1159.82, "standard_charge_percentage": 78.5000, "estimated_amount": 1159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1248.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1248, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 635.96, "standard_charge_percentage": 39.6000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1197.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1445.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1445.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1260.67, "standard_charge_percentage": 78.5000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1204.46, "standard_charge_percentage": 75.0000, "estimated_amount": 1204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 963.57, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 802.98, "standard_charge_percentage": 50.0000, "estimated_amount": 802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1445.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1445, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 802.98, "standard_charge_percentage": 50.0000, "estimated_amount": 802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1197.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc tr-ext b9+marg 2.1-3cm", "code_information": [ { "code": "11403", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18511.4, "discounted_cash": 821,"minimum": 243.24,"maximum": 18511.4,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14095.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13804.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14531.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14531, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18141.2, "standard_charge_percentage": 98.0000, "estimated_amount": 18141, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18511.4, "standard_charge_percentage": 100.0000, "estimated_amount": 18511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14095.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13078.3, "standard_charge_percentage": 78.5000, "estimated_amount": 13078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16197.5, "standard_charge_percentage": 87.5000, "estimated_amount": 16197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16660.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16660, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14095.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17585.8, "standard_charge_percentage": 95.0000, "estimated_amount": 17585, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14095.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14095, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13804.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13804, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9255.7, "standard_charge_percentage": 50.0000, "estimated_amount": 9255, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13368.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13368, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15734.7, "standard_charge_percentage": 85.0000, "estimated_amount": 15734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9255.7, "standard_charge_percentage": 50.0000, "estimated_amount": 9255, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14386.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14531.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14531, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14095.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14095, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7330.51, "standard_charge_percentage": 39.6000, "estimated_amount": 7330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5553.42, "standard_charge_percentage": 30.0000, "estimated_amount": 5553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14531.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14531, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15734.7, "standard_charge_percentage": 85.0000, "estimated_amount": 15734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16660.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16660, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16660.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16660, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 13883.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17585.8, "standard_charge_percentage": 95.0000, "estimated_amount": 17585, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10181.3, "standard_charge_percentage": 55.0000, "estimated_amount": 10181, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9255.7, "standard_charge_percentage": 50.0000, "estimated_amount": 9255, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14809.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14809, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc tr-ext b9+marg 3.1-4 cm", "code_information": [ { "code": "11404", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19254.2, "discounted_cash": 1892,"minimum": 243.24,"maximum": 19254.2,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" }]}]} , { "description": "Exc tr-ext b9+marg >4.0 cm", "code_information": [ { "code": "11406", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19634.1, "discounted_cash": 1892,"minimum": 325.58,"maximum": 19634.1,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18652.4, "standard_charge_percentage": 95.0000, "estimated_amount": 18652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14179.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14179, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19241.4, "standard_charge_percentage": 98.0000, "estimated_amount": 19241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10798.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19634.1, "standard_charge_percentage": 100.0000, "estimated_amount": 19634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17179.8, "standard_charge_percentage": 87.5000, "estimated_amount": 17179, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16689, "standard_charge_percentage": 85.0000, "estimated_amount": 16688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7775.1, "standard_charge_percentage": 39.6000, "estimated_amount": 7775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14642.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15258.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18652.4, "standard_charge_percentage": 95.0000, "estimated_amount": 18652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13871.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16689, "standard_charge_percentage": 85.0000, "estimated_amount": 16688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14642.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14725.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14725, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5890.23, "standard_charge_percentage": 30.0000, "estimated_amount": 5890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" }]}]} , { "description": "EXC MAL LES SCLP HND 1.1-2.0CM", "code_information": [ { "code": "11420", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1664, "discounted_cash": 1892,"minimum": 243.24,"maximum": 19254.2,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1306.24, "standard_charge_percentage": 78.5000, "estimated_amount": 1306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 832, "standard_charge_percentage": 50.0000, "estimated_amount": 832, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1497.6, "standard_charge_percentage": 90.0000, "estimated_amount": 1497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1664, "standard_charge_percentage": 100.0000, "estimated_amount": 1664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 665.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1580.8, "standard_charge_percentage": 95.0000, "estimated_amount": 1580, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1267.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 915.2, "standard_charge_percentage": 55.0000, "estimated_amount": 915, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1456, "standard_charge_percentage": 87.5000, "estimated_amount": 1456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1267.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1664, "estimated_amount": 1664, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1664, "estimated_amount": 1664, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 998.4, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1240.93, "standard_charge_percentage": 78.5000, "estimated_amount": 1240, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1664, "estimated_amount": 1664, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1240.93, "standard_charge_percentage": 78.5000, "estimated_amount": 1240, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1497.6, "standard_charge_percentage": 90.0000, "estimated_amount": 1497, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1414.4, "standard_charge_percentage": 85.0000, "estimated_amount": 1414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1293.18, "standard_charge_percentage": 78.5000, "estimated_amount": 1293, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1306.24, "standard_charge_percentage": 78.5000, "estimated_amount": 1306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1267.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1630.72, "standard_charge_percentage": 98.0000, "estimated_amount": 1630, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 832, "standard_charge_percentage": 50.0000, "estimated_amount": 832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1306.24, "standard_charge_percentage": 78.5000, "estimated_amount": 1306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 832, "standard_charge_percentage": 50.0000, "estimated_amount": 832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1580.8, "standard_charge_percentage": 95.0000, "estimated_amount": 1580, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1248, "standard_charge_percentage": 75.0000, "estimated_amount": 1248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1497.6, "standard_charge_percentage": 90.0000, "estimated_amount": 1497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1267.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 499.2, "standard_charge_percentage": 30.0000, "estimated_amount": 499, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1664, "estimated_amount": 1664, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1175.62, "standard_charge_percentage": 78.5000, "estimated_amount": 1175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1267.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 658.94, "standard_charge_percentage": 39.6000, "estimated_amount": 658, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1201.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1201, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1414.4, "standard_charge_percentage": 85.0000, "estimated_amount": 1414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1331.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc h-f-nk-sp b9+marg 0.6-1", "code_information": [ { "code": "11421", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19254.2, "discounted_cash": 821,"minimum": 243.24,"maximum": 19254.2,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1310.7, "standard_charge_percentage": 85.0000, "estimated_amount": 1310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1210.47, "standard_charge_percentage": 78.5000, "estimated_amount": 1210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1198.37, "standard_charge_percentage": 78.5000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1149.95, "standard_charge_percentage": 78.5000, "estimated_amount": 1149, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1156.5, "standard_charge_percentage": 75.0000, "estimated_amount": 1156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 848.1, "standard_charge_percentage": 55.0000, "estimated_amount": 848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1174.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1174, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1387.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 616.8, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1464.9, "standard_charge_percentage": 95.0000, "estimated_amount": 1464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 462.6, "standard_charge_percentage": 30.0000, "estimated_amount": 462, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 771, "standard_charge_percentage": 50.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1149.95, "standard_charge_percentage": 78.5000, "estimated_amount": 1149, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1511.16, "standard_charge_percentage": 98.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1174.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1174, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1174.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 771, "standard_charge_percentage": 50.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1113.63, "standard_charge_percentage": 78.5000, "estimated_amount": 1113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1310.7, "standard_charge_percentage": 85.0000, "estimated_amount": 1310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1089.42, "standard_charge_percentage": 78.5000, "estimated_amount": 1089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1387.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 925.2, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1174.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1542, "standard_charge_percentage": 100.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 610.63, "standard_charge_percentage": 39.6000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1387.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1464.9, "standard_charge_percentage": 95.0000, "estimated_amount": 1464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 771, "standard_charge_percentage": 50.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1210.47, "standard_charge_percentage": 78.5000, "estimated_amount": 1210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1174.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1233.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1349.25, "standard_charge_percentage": 87.5000, "estimated_amount": 1349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1210.47, "standard_charge_percentage": 78.5000, "estimated_amount": 1210, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc h-f-nk-sp b9+marg 1.1-2", "code_information": [ { "code": "11422", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1913, "discounted_cash": 1892,"minimum": 243.24,"maximum": 19254.2,"payers_information":[{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 765.2, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 765, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1721.7, "standard_charge_percentage": 90.0000, "estimated_amount": 1721, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1381.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 956.5, "standard_charge_percentage": 50.0000, "estimated_amount": 956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 956.5, "standard_charge_percentage": 50.0000, "estimated_amount": 956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1817.35, "standard_charge_percentage": 95.0000, "estimated_amount": 1817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1501.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1913, "estimated_amount": 1913, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1721.7, "standard_charge_percentage": 90.0000, "estimated_amount": 1721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1456.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 573.9, "standard_charge_percentage": 30.0000, "estimated_amount": 573, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1486.69, "standard_charge_percentage": 78.5000, "estimated_amount": 1486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1456.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1501.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1721.7, "standard_charge_percentage": 90.0000, "estimated_amount": 1721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1456.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1434.75, "standard_charge_percentage": 75.0000, "estimated_amount": 1434, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1147.8, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1456.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1456, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1913, "estimated_amount": 1913, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1817.35, "standard_charge_percentage": 95.0000, "estimated_amount": 1817, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1501.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1052.15, "standard_charge_percentage": 55.0000, "estimated_amount": 1052, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1351.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1913, "estimated_amount": 1913, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1426.62, "standard_charge_percentage": 78.5000, "estimated_amount": 1426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 757.55, "standard_charge_percentage": 39.6000, "estimated_amount": 757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1913, "standard_charge_percentage": 100.0000, "estimated_amount": 1913, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1456.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1426.62, "standard_charge_percentage": 78.5000, "estimated_amount": 1426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1913, "estimated_amount": 1913, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1626.05, "standard_charge_percentage": 85.0000, "estimated_amount": 1626, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1673.88, "standard_charge_percentage": 87.5000, "estimated_amount": 1673, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 956.5, "standard_charge_percentage": 50.0000, "estimated_amount": 956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1530.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1626.05, "standard_charge_percentage": 85.0000, "estimated_amount": 1626, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1874.74, "standard_charge_percentage": 98.0000, "estimated_amount": 1874, "methodology": "percent of total billed charges" }]}]} , { "description": "EXC LES ABD WALL SUBQ 3CM/>", "code_information": [ { "code": "11423", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2713.26, "discounted_cash": 1892,"minimum": 243.24,"maximum": 2713.26,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2023.41, "standard_charge_percentage": 78.5000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2577.6, "standard_charge_percentage": 95.0000, "estimated_amount": 2577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2441.93, "standard_charge_percentage": 90.0000, "estimated_amount": 2441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2306.27, "standard_charge_percentage": 85.0000, "estimated_amount": 2306, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 813.98, "standard_charge_percentage": 30.0000, "estimated_amount": 813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2374.1, "standard_charge_percentage": 87.5000, "estimated_amount": 2374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2577.6, "standard_charge_percentage": 95.0000, "estimated_amount": 2577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2713.26, "standard_charge_percentage": 100.0000, "estimated_amount": 2713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2023.41, "standard_charge_percentage": 78.5000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1074.45, "standard_charge_percentage": 39.6000, "estimated_amount": 1074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1492.29, "standard_charge_percentage": 55.0000, "estimated_amount": 1492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2034.95, "standard_charge_percentage": 75.0000, "estimated_amount": 2034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1627.96, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2306.27, "standard_charge_percentage": 85.0000, "estimated_amount": 2306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2129.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2129.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2129, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1356.63, "standard_charge_percentage": 50.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2658.99, "standard_charge_percentage": 98.0000, "estimated_amount": 2658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2713.26, "estimated_amount": 2713, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1959.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1959, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1356.63, "standard_charge_percentage": 50.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1356.63, "standard_charge_percentage": 50.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2108.61, "standard_charge_percentage": 78.5000, "estimated_amount": 2108, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1916.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2129.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2441.93, "standard_charge_percentage": 90.0000, "estimated_amount": 2441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1085.3, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1085, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2441.93, "standard_charge_percentage": 90.0000, "estimated_amount": 2441, "methodology": "percent of total billed charges" }]}]} , { "description": "BIOPSY SOFT TISSUE NECK/THORAX", "code_information": [ { "code": "11424", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2884, "discounted_cash": 1892,"minimum": 243.24,"maximum": 2884,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2523.5, "standard_charge_percentage": 87.5000, "estimated_amount": 2523, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2150.74, "standard_charge_percentage": 78.5000, "estimated_amount": 2150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2451.4, "standard_charge_percentage": 85.0000, "estimated_amount": 2451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2196.02, "standard_charge_percentage": 78.5000, "estimated_amount": 2196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2595.6, "standard_charge_percentage": 90.0000, "estimated_amount": 2595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2263.94, "standard_charge_percentage": 78.5000, "estimated_amount": 2263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2451.4, "standard_charge_percentage": 85.0000, "estimated_amount": 2451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2263.94, "standard_charge_percentage": 78.5000, "estimated_amount": 2263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2739.8, "standard_charge_percentage": 95.0000, "estimated_amount": 2739, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2196.02, "standard_charge_percentage": 78.5000, "estimated_amount": 2196, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1142.06, "standard_charge_percentage": 39.6000, "estimated_amount": 1142, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2826.32, "standard_charge_percentage": 98.0000, "estimated_amount": 2826, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1442, "standard_charge_percentage": 50.0000, "estimated_amount": 1442, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 865.2, "standard_charge_percentage": 30.0000, "estimated_amount": 865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1442, "standard_charge_percentage": 50.0000, "estimated_amount": 1442, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2037.55, "standard_charge_percentage": 78.5000, "estimated_amount": 2037, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2196.02, "standard_charge_percentage": 78.5000, "estimated_amount": 2196, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2196.02, "standard_charge_percentage": 78.5000, "estimated_amount": 2196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2884, "standard_charge_percentage": 100.0000, "estimated_amount": 2884, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2595.6, "standard_charge_percentage": 90.0000, "estimated_amount": 2595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2150.74, "standard_charge_percentage": 78.5000, "estimated_amount": 2150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2241.3, "standard_charge_percentage": 78.5000, "estimated_amount": 2241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2307.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2263.94, "standard_charge_percentage": 78.5000, "estimated_amount": 2263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1730.4, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2082.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2082, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2884, "estimated_amount": 2884, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2163, "standard_charge_percentage": 75.0000, "estimated_amount": 2163, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1586.2, "standard_charge_percentage": 55.0000, "estimated_amount": 1586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2739.8, "standard_charge_percentage": 95.0000, "estimated_amount": 2739, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2196.02, "standard_charge_percentage": 78.5000, "estimated_amount": 2196, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2595.6, "standard_charge_percentage": 90.0000, "estimated_amount": 2595, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1442, "standard_charge_percentage": 50.0000, "estimated_amount": 1442, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Exc Skin Benig >4 Cm Scalp/Neck/Hnd/Ft/Gent", "code_information": [ { "code": "11426", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3694, "discounted_cash": 3342,"minimum": 243.24,"maximum": 3694,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2812.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3694, "estimated_amount": 3694, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1847, "standard_charge_percentage": 50.0000, "estimated_amount": 1847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2770.5, "standard_charge_percentage": 75.0000, "estimated_amount": 2770, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2031.7, "standard_charge_percentage": 55.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1108.2, "standard_charge_percentage": 30.0000, "estimated_amount": 1108, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2812.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2812.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2812, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2899.79, "standard_charge_percentage": 78.5000, "estimated_amount": 2899, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1847, "standard_charge_percentage": 50.0000, "estimated_amount": 1847, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3620.12, "standard_charge_percentage": 98.0000, "estimated_amount": 3620, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3509.3, "standard_charge_percentage": 95.0000, "estimated_amount": 3509, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2216.4, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2216, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3139.9, "standard_charge_percentage": 85.0000, "estimated_amount": 3139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3694, "standard_charge_percentage": 100.0000, "estimated_amount": 3694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2899.79, "standard_charge_percentage": 78.5000, "estimated_amount": 2899, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1462.82, "standard_charge_percentage": 39.6000, "estimated_amount": 1462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1477.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1477, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3324.6, "standard_charge_percentage": 90.0000, "estimated_amount": 3324, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3232.25, "standard_charge_percentage": 87.5000, "estimated_amount": 3232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2609.81, "standard_charge_percentage": 78.5000, "estimated_amount": 2609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2812.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2899.79, "standard_charge_percentage": 78.5000, "estimated_amount": 2899, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3694, "estimated_amount": 3694, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3509.3, "standard_charge_percentage": 95.0000, "estimated_amount": 3509, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3694, "estimated_amount": 3694, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2812.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2812, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3324.6, "standard_charge_percentage": 90.0000, "estimated_amount": 3324, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1847, "standard_charge_percentage": 50.0000, "estimated_amount": 1847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2870.79, "standard_charge_percentage": 78.5000, "estimated_amount": 2870, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2754.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2754, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3139.9, "standard_charge_percentage": 85.0000, "estimated_amount": 3139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2667.81, "standard_charge_percentage": 78.5000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2955.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3324.6, "standard_charge_percentage": 90.0000, "estimated_amount": 3324, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2754.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" }]}]} , { "description": "Exc face-mm b9+marg 0.5 cm<", "code_information": [ { "code": "11440", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1141.58, "discounted_cash": 821,"minimum": 243.24,"maximum": 1141.58,"payers_information":[{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 570.79, "standard_charge_percentage": 50.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 869.26, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 570.79, "standard_charge_percentage": 50.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 684.95, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1084.5, "standard_charge_percentage": 95.0000, "estimated_amount": 1084, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 887.18, "standard_charge_percentage": 78.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 869.26, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 856.18, "standard_charge_percentage": 75.0000, "estimated_amount": 856, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 824.45, "standard_charge_percentage": 78.5000, "estimated_amount": 824, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 456.63, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 970.34, "standard_charge_percentage": 85.0000, "estimated_amount": 970, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 806.53, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1141.58, "standard_charge_percentage": 100.0000, "estimated_amount": 1141, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 452.07, "standard_charge_percentage": 39.6000, "estimated_amount": 452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 998.88, "standard_charge_percentage": 87.5000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1027.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 627.87, "standard_charge_percentage": 55.0000, "estimated_amount": 627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 896.14, "standard_charge_percentage": 78.5000, "estimated_amount": 896, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 570.79, "standard_charge_percentage": 50.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 896.14, "standard_charge_percentage": 78.5000, "estimated_amount": 896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 869.26, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 869.26, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 869.26, "standard_charge_percentage": 78.5000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1027.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 851.33, "standard_charge_percentage": 78.5000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 970.34, "standard_charge_percentage": 85.0000, "estimated_amount": 970, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1141.58, "estimated_amount": 1141, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1118.75, "standard_charge_percentage": 98.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 851.33, "standard_charge_percentage": 78.5000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 896.14, "standard_charge_percentage": 78.5000, "estimated_amount": 896, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1027.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1084.5, "standard_charge_percentage": 95.0000, "estimated_amount": 1084, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 342.47, "standard_charge_percentage": 30.0000, "estimated_amount": 342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 913.26, "standard_charge_percentage": 80.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" }]}]} , { "description": "Exc face-mm b9+marg 0.6-1 cm", "code_information": [ { "code": "11441", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1572, "discounted_cash": 821,"minimum": 243.24,"maximum": 1572,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 471.6, "standard_charge_percentage": 30.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1135.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 786, "standard_charge_percentage": 50.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1197, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1172.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1493.4, "standard_charge_percentage": 95.0000, "estimated_amount": 1493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1493.4, "standard_charge_percentage": 95.0000, "estimated_amount": 1493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 943.2, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 864.6, "standard_charge_percentage": 55.0000, "estimated_amount": 864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1172.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 786, "standard_charge_percentage": 50.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1414.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1197, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1572, "standard_charge_percentage": 100.0000, "estimated_amount": 1572, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 786, "standard_charge_percentage": 50.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 622.51, "standard_charge_percentage": 39.6000, "estimated_amount": 622, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1540.56, "standard_charge_percentage": 98.0000, "estimated_amount": 1540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1234.02, "standard_charge_percentage": 78.5000, "estimated_amount": 1234, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1336.2, "standard_charge_percentage": 85.0000, "estimated_amount": 1336, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1234.02, "standard_charge_percentage": 78.5000, "estimated_amount": 1234, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1414.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1197, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1197, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1336.2, "standard_charge_percentage": 85.0000, "estimated_amount": 1336, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1414.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1234.02, "standard_charge_percentage": 78.5000, "estimated_amount": 1234, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1197, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1257.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1375.5, "standard_charge_percentage": 87.5000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 628.8, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1179, "standard_charge_percentage": 75.0000, "estimated_amount": 1179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1110.62, "standard_charge_percentage": 78.5000, "estimated_amount": 1110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1221.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1221, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc face-mm b9+marg 1.1-2 cm", "code_information": [ { "code": "11442", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1605.95, "discounted_cash": 821,"minimum": 243.24,"maximum": 1605.95,"payers_information":[{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1197.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1204.46, "standard_charge_percentage": 75.0000, "estimated_amount": 1204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1445.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1445, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1197.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 635.96, "standard_charge_percentage": 39.6000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 642.38, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1248.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 802.98, "standard_charge_percentage": 50.0000, "estimated_amount": 802, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 802.98, "standard_charge_percentage": 50.0000, "estimated_amount": 802, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1159.82, "standard_charge_percentage": 78.5000, "estimated_amount": 1159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1365.06, "standard_charge_percentage": 85.0000, "estimated_amount": 1365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1525.65, "standard_charge_percentage": 95.0000, "estimated_amount": 1525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1260.67, "standard_charge_percentage": 78.5000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1445.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 883.27, "standard_charge_percentage": 55.0000, "estimated_amount": 883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1445.36, "standard_charge_percentage": 90.0000, "estimated_amount": 1445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 963.57, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1134.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1134, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1365.06, "standard_charge_percentage": 85.0000, "estimated_amount": 1365, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 481.79, "standard_charge_percentage": 30.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1260.67, "standard_charge_percentage": 78.5000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1525.65, "standard_charge_percentage": 95.0000, "estimated_amount": 1525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1573.83, "standard_charge_percentage": 98.0000, "estimated_amount": 1573, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1605.95, "standard_charge_percentage": 100.0000, "estimated_amount": 1605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1405.21, "standard_charge_percentage": 87.5000, "estimated_amount": 1405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 802.98, "standard_charge_percentage": 50.0000, "estimated_amount": 802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1222.85, "standard_charge_percentage": 78.5000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1260.67, "standard_charge_percentage": 78.5000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1284.76, "standard_charge_percentage": 80.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc face-mm b9+marg 2.1-3 cm", "code_information": [ { "code": "11443", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2063.57, "discounted_cash": 1892,"minimum": 243.24,"maximum": 2063.57,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1031.79, "standard_charge_percentage": 50.0000, "estimated_amount": 1031, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1457.91, "standard_charge_percentage": 78.5000, "estimated_amount": 1457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2022.3, "standard_charge_percentage": 98.0000, "estimated_amount": 2022, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1538.91, "standard_charge_percentage": 78.5000, "estimated_amount": 1538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1805.62, "standard_charge_percentage": 87.5000, "estimated_amount": 1805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 825.43, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1857.21, "standard_charge_percentage": 90.0000, "estimated_amount": 1857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1857.21, "standard_charge_percentage": 90.0000, "estimated_amount": 1857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1754.03, "standard_charge_percentage": 85.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1547.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1547, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 817.17, "standard_charge_percentage": 39.6000, "estimated_amount": 817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1960.39, "standard_charge_percentage": 95.0000, "estimated_amount": 1960, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1619.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2063.57, "estimated_amount": 2063, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2063.57, "estimated_amount": 2063, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1490.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1619.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1619, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1031.79, "standard_charge_percentage": 50.0000, "estimated_amount": 1031, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1754.03, "standard_charge_percentage": 85.0000, "estimated_amount": 1754, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1603.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2063.57, "standard_charge_percentage": 100.0000, "estimated_amount": 2063, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1571.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2063.57, "estimated_amount": 2063, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1571.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1134.96, "standard_charge_percentage": 55.0000, "estimated_amount": 1134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1031.79, "standard_charge_percentage": 50.0000, "estimated_amount": 1031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1960.39, "standard_charge_percentage": 95.0000, "estimated_amount": 1960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1538.91, "standard_charge_percentage": 78.5000, "estimated_amount": 1538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1238.14, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 619.07, "standard_charge_percentage": 30.0000, "estimated_amount": 619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1571.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1619.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1571.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1571.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1857.21, "standard_charge_percentage": 90.0000, "estimated_amount": 1857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1650.86, "standard_charge_percentage": 80.0000, "estimated_amount": 1650, "methodology": "percent of total billed charges" }]}]} , { "description": "CT GUIDE FNA BX 1ST LESION", "code_information": [ { "code": "11444", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3767.92, "discounted_cash": 1892,"minimum": 243.24,"maximum": 3767.92,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3579.52, "standard_charge_percentage": 95.0000, "estimated_amount": 3579, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2928.24, "standard_charge_percentage": 78.5000, "estimated_amount": 2928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3391.13, "standard_charge_percentage": 90.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2072.36, "standard_charge_percentage": 55.0000, "estimated_amount": 2072, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1883.96, "standard_charge_percentage": 50.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2809.93, "standard_charge_percentage": 78.5000, "estimated_amount": 2809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2809.93, "standard_charge_percentage": 78.5000, "estimated_amount": 2809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3391.13, "standard_charge_percentage": 90.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2721.19, "standard_charge_percentage": 78.5000, "estimated_amount": 2721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3767.92, "standard_charge_percentage": 100.0000, "estimated_amount": 3767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2957.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2957, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1883.96, "standard_charge_percentage": 50.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2662.04, "standard_charge_percentage": 78.5000, "estimated_amount": 2662, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1130.38, "standard_charge_percentage": 30.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1883.96, "standard_charge_percentage": 50.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2957.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2957, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3579.52, "standard_charge_percentage": 95.0000, "estimated_amount": 3579, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1507.17, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2957.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2957, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3296.93, "standard_charge_percentage": 87.5000, "estimated_amount": 3296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1492.1, "standard_charge_percentage": 39.6000, "estimated_amount": 1492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3692.56, "standard_charge_percentage": 98.0000, "estimated_amount": 3692, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3202.73, "standard_charge_percentage": 85.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2825.94, "standard_charge_percentage": 75.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3202.73, "standard_charge_percentage": 85.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3391.13, "standard_charge_percentage": 90.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc face-mm b9+marg >4 cm", "code_information": [ { "code": "11446", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9121.55, "discounted_cash": 3342,"minimum": 243.24,"maximum": 9121.55,"payers_information":[{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3612.13, "standard_charge_percentage": 39.6000, "estimated_amount": 3612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5016.85, "standard_charge_percentage": 55.0000, "estimated_amount": 5016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6802.4, "standard_charge_percentage": 78.5000, "estimated_amount": 6802, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 7981.36, "standard_charge_percentage": 87.5000, "estimated_amount": 7981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 8665.47, "standard_charge_percentage": 95.0000, "estimated_amount": 8665, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6587.58, "standard_charge_percentage": 78.5000, "estimated_amount": 6587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9121.55, "standard_charge_percentage": 100.0000, "estimated_amount": 9121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7753.32, "standard_charge_percentage": 85.0000, "estimated_amount": 7753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 8665.47, "standard_charge_percentage": 95.0000, "estimated_amount": 8665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6444.38, "standard_charge_percentage": 78.5000, "estimated_amount": 6444, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3648.62, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7088.81, "standard_charge_percentage": 78.5000, "estimated_amount": 7088, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2736.47, "standard_charge_percentage": 30.0000, "estimated_amount": 2736, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 8939.12, "standard_charge_percentage": 98.0000, "estimated_amount": 8939, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7753.32, "standard_charge_percentage": 85.0000, "estimated_amount": 7753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6802.4, "standard_charge_percentage": 78.5000, "estimated_amount": 6802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6841.16, "standard_charge_percentage": 75.0000, "estimated_amount": 6841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc skn hdrdnt ax complex", "code_information": [ { "code": "11451", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 22188.4, "discounted_cash": 3342,"minimum": 243.24,"maximum": 22188.4,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 18860.1, "standard_charge_percentage": 85.0000, "estimated_amount": 18860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 16547, "standard_charge_percentage": 78.5000, "estimated_amount": 16547, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 22188.4, "standard_charge_percentage": 100.0000, "estimated_amount": 22188, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6656.52, "standard_charge_percentage": 30.0000, "estimated_amount": 6656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 21079, "standard_charge_percentage": 95.0000, "estimated_amount": 21078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8786.61, "standard_charge_percentage": 39.6000, "estimated_amount": 8786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 16641.3, "standard_charge_percentage": 75.0000, "estimated_amount": 16641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 15676.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16024.5, "standard_charge_percentage": 78.5000, "estimated_amount": 16024, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12203.6, "standard_charge_percentage": 55.0000, "estimated_amount": 12203, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 19414.8, "standard_charge_percentage": 87.5000, "estimated_amount": 19414, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21079, "standard_charge_percentage": 95.0000, "estimated_amount": 21078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 16547, "standard_charge_percentage": 78.5000, "estimated_amount": 16547, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 21744.6, "standard_charge_percentage": 98.0000, "estimated_amount": 21744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 17243.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 18860.1, "standard_charge_percentage": 85.0000, "estimated_amount": 18860, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc skn hdrdnt ing complex", "code_information": [ { "code": "11463", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19254.2, "discounted_cash": 3342,"minimum": 243.24,"maximum": 19254.2,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11601", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7065.93, "discounted_cash": 821,"minimum": 243.24,"maximum": 7065.93,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3532.97, "standard_charge_percentage": 50.0000, "estimated_amount": 3532, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6924.61, "standard_charge_percentage": 98.0000, "estimated_amount": 6924, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6006.04, "standard_charge_percentage": 85.0000, "estimated_amount": 6006, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5546.76, "standard_charge_percentage": 78.5000, "estimated_amount": 5546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5103.01, "standard_charge_percentage": 78.5000, "estimated_amount": 5103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6359.34, "standard_charge_percentage": 90.0000, "estimated_amount": 6359, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5380.35, "standard_charge_percentage": 78.5000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2798.11, "standard_charge_percentage": 39.6000, "estimated_amount": 2798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5380.35, "standard_charge_percentage": 78.5000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3886.26, "standard_charge_percentage": 55.0000, "estimated_amount": 3886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5269.42, "standard_charge_percentage": 78.5000, "estimated_amount": 5269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6359.34, "standard_charge_percentage": 90.0000, "estimated_amount": 6359, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6182.69, "standard_charge_percentage": 87.5000, "estimated_amount": 6182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5546.76, "standard_charge_percentage": 78.5000, "estimated_amount": 5546, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3532.97, "standard_charge_percentage": 50.0000, "estimated_amount": 3532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5380.35, "standard_charge_percentage": 78.5000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2119.78, "standard_charge_percentage": 30.0000, "estimated_amount": 2119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5380.35, "standard_charge_percentage": 78.5000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6712.63, "standard_charge_percentage": 95.0000, "estimated_amount": 6712, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5546.76, "standard_charge_percentage": 78.5000, "estimated_amount": 5546, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5380.35, "standard_charge_percentage": 78.5000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2826.37, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7065.93, "standard_charge_percentage": 100.0000, "estimated_amount": 7065, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3532.97, "standard_charge_percentage": 50.0000, "estimated_amount": 3532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4992.08, "standard_charge_percentage": 78.5000, "estimated_amount": 4992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5491.29, "standard_charge_percentage": 78.5000, "estimated_amount": 5491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5652.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5269.42, "standard_charge_percentage": 78.5000, "estimated_amount": 5269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5299.45, "standard_charge_percentage": 75.0000, "estimated_amount": 5299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6006.04, "standard_charge_percentage": 85.0000, "estimated_amount": 6006, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6712.63, "standard_charge_percentage": 95.0000, "estimated_amount": 6712, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6359.34, "standard_charge_percentage": 90.0000, "estimated_amount": 6359, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11603", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 16108.6, "discounted_cash": 821,"minimum": 243.24,"maximum": 16108.6,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 12265.9, "standard_charge_percentage": 78.5000, "estimated_amount": 12265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 15303.2, "standard_charge_percentage": 95.0000, "estimated_amount": 15303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 8054.31, "standard_charge_percentage": 50.0000, "estimated_amount": 8054, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 11633.6, "standard_charge_percentage": 78.5000, "estimated_amount": 11633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 15303.2, "standard_charge_percentage": 95.0000, "estimated_amount": 15303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 11380.7, "standard_charge_percentage": 78.5000, "estimated_amount": 11380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 8054.31, "standard_charge_percentage": 50.0000, "estimated_amount": 8054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 14095, "standard_charge_percentage": 87.5000, "estimated_amount": 14095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 16108.6, "standard_charge_percentage": 100.0000, "estimated_amount": 16108, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 14497.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 12265.9, "standard_charge_percentage": 78.5000, "estimated_amount": 12265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 14497.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 12518.8, "standard_charge_percentage": 78.5000, "estimated_amount": 12518, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 8859.74, "standard_charge_percentage": 55.0000, "estimated_amount": 8859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 12265.9, "standard_charge_percentage": 78.5000, "estimated_amount": 12265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 12645.3, "standard_charge_percentage": 78.5000, "estimated_amount": 12645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 15786.4, "standard_charge_percentage": 98.0000, "estimated_amount": 15786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 12645.3, "standard_charge_percentage": 78.5000, "estimated_amount": 12645, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 12081.5, "standard_charge_percentage": 75.0000, "estimated_amount": 12081, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 8054.31, "standard_charge_percentage": 50.0000, "estimated_amount": 8054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 12265.9, "standard_charge_percentage": 78.5000, "estimated_amount": 12265, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 6379.01, "standard_charge_percentage": 39.6000, "estimated_amount": 6379, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 12886.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 12013, "standard_charge_percentage": 78.5000, "estimated_amount": 12013, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 13692.3, "standard_charge_percentage": 85.0000, "estimated_amount": 13692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 13692.3, "standard_charge_percentage": 85.0000, "estimated_amount": 13692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 12013, "standard_charge_percentage": 78.5000, "estimated_amount": 12013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 12265.9, "standard_charge_percentage": 78.5000, "estimated_amount": 12265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 14497.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4832.58, "standard_charge_percentage": 30.0000, "estimated_amount": 4832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12645.3, "standard_charge_percentage": 78.5000, "estimated_amount": 12645, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11604", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9289.24, "discounted_cash": 821,"minimum": 243.24,"maximum": 9289.24,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7073.29, "standard_charge_percentage": 78.5000, "estimated_amount": 7073, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4644.62, "standard_charge_percentage": 50.0000, "estimated_amount": 4644, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6708.69, "standard_charge_percentage": 78.5000, "estimated_amount": 6708, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9103.46, "standard_charge_percentage": 98.0000, "estimated_amount": 9103, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7292.05, "standard_charge_percentage": 78.5000, "estimated_amount": 7292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7292.05, "standard_charge_percentage": 78.5000, "estimated_amount": 7292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5109.08, "standard_charge_percentage": 55.0000, "estimated_amount": 5109, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8360.32, "standard_charge_percentage": 90.0000, "estimated_amount": 8360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7219.13, "standard_charge_percentage": 78.5000, "estimated_amount": 7219, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6966.93, "standard_charge_percentage": 75.0000, "estimated_amount": 6966, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7073.29, "standard_charge_percentage": 78.5000, "estimated_amount": 7073, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7073.29, "standard_charge_percentage": 78.5000, "estimated_amount": 7073, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3715.7, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3715, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7073.29, "standard_charge_percentage": 78.5000, "estimated_amount": 7073, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 8824.78, "standard_charge_percentage": 95.0000, "estimated_amount": 8824, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7895.85, "standard_charge_percentage": 85.0000, "estimated_amount": 7895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8360.32, "standard_charge_percentage": 90.0000, "estimated_amount": 8360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2786.77, "standard_charge_percentage": 30.0000, "estimated_amount": 2786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6562.85, "standard_charge_percentage": 78.5000, "estimated_amount": 6562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8360.32, "standard_charge_percentage": 90.0000, "estimated_amount": 8360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8128.09, "standard_charge_percentage": 87.5000, "estimated_amount": 8128, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 8824.78, "standard_charge_percentage": 95.0000, "estimated_amount": 8824, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7292.05, "standard_charge_percentage": 78.5000, "estimated_amount": 7292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4644.62, "standard_charge_percentage": 50.0000, "estimated_amount": 4644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9289.24, "standard_charge_percentage": 100.0000, "estimated_amount": 9289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3678.54, "standard_charge_percentage": 39.6000, "estimated_amount": 3678, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4644.62, "standard_charge_percentage": 50.0000, "estimated_amount": 4644, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7073.29, "standard_charge_percentage": 78.5000, "estimated_amount": 7073, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7895.85, "standard_charge_percentage": 85.0000, "estimated_amount": 7895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7431.39, "standard_charge_percentage": 80.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6927.45, "standard_charge_percentage": 78.5000, "estimated_amount": 6927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6927.45, "standard_charge_percentage": 78.5000, "estimated_amount": 6927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11606", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 14422.4, "discounted_cash": 1892,"minimum": 243.24,"maximum": 14422.4,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 10981.9, "standard_charge_percentage": 78.5000, "estimated_amount": 10981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 12980.1, "standard_charge_percentage": 90.0000, "estimated_amount": 12980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 10981.9, "standard_charge_percentage": 78.5000, "estimated_amount": 10981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 10981.9, "standard_charge_percentage": 78.5000, "estimated_amount": 10981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 7932.29, "standard_charge_percentage": 55.0000, "estimated_amount": 7932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 11321.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11321, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 12259, "standard_charge_percentage": 85.0000, "estimated_amount": 12259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 12980.1, "standard_charge_percentage": 90.0000, "estimated_amount": 12980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 10816.8, "standard_charge_percentage": 75.0000, "estimated_amount": 10816, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 11321.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11321, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 10981.9, "standard_charge_percentage": 78.5000, "estimated_amount": 10981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 7211.18, "standard_charge_percentage": 50.0000, "estimated_amount": 7211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 12619.6, "standard_charge_percentage": 87.5000, "estimated_amount": 12619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 11208.3, "standard_charge_percentage": 78.5000, "estimated_amount": 11208, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 7211.18, "standard_charge_percentage": 50.0000, "estimated_amount": 7211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 11321.5, "standard_charge_percentage": 78.5000, "estimated_amount": 11321, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 5711.25, "standard_charge_percentage": 39.6000, "estimated_amount": 5711, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 10981.9, "standard_charge_percentage": 78.5000, "estimated_amount": 10981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 13701.2, "standard_charge_percentage": 95.0000, "estimated_amount": 13701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4326.7, "standard_charge_percentage": 30.0000, "estimated_amount": 4326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 7211.18, "standard_charge_percentage": 50.0000, "estimated_amount": 7211, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 10189.4, "standard_charge_percentage": 78.5000, "estimated_amount": 10189, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 13701.2, "standard_charge_percentage": 95.0000, "estimated_amount": 13701, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 10415.8, "standard_charge_percentage": 78.5000, "estimated_amount": 10415, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 12259, "standard_charge_percentage": 85.0000, "estimated_amount": 12259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 12980.1, "standard_charge_percentage": 90.0000, "estimated_amount": 12980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 14422.4, "standard_charge_percentage": 100.0000, "estimated_amount": 14422, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 14133.9, "standard_charge_percentage": 98.0000, "estimated_amount": 14133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 10755.5, "standard_charge_percentage": 78.5000, "estimated_amount": 10755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 10755.5, "standard_charge_percentage": 78.5000, "estimated_amount": 10755, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 11537.9, "standard_charge_percentage": 80.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc h-f-nk-sp mal+marg 0.5<", "code_information": [ { "code": "11620", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 985.86, "discounted_cash": 1892,"minimum": 243.24,"maximum": 985.86,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 966.14, "standard_charge_percentage": 98.0000, "estimated_amount": 966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 735.21, "standard_charge_percentage": 78.5000, "estimated_amount": 735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 862.63, "standard_charge_percentage": 87.5000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 394.34, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 542.22, "standard_charge_percentage": 55.0000, "estimated_amount": 542, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 750.68, "standard_charge_percentage": 78.5000, "estimated_amount": 750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 750.68, "standard_charge_percentage": 78.5000, "estimated_amount": 750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 936.57, "standard_charge_percentage": 95.0000, "estimated_amount": 936, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 711.99, "standard_charge_percentage": 78.5000, "estimated_amount": 711, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 887.27, "standard_charge_percentage": 90.0000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 837.98, "standard_charge_percentage": 85.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 390.4, "standard_charge_percentage": 39.6000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 750.68, "standard_charge_percentage": 78.5000, "estimated_amount": 750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 773.9, "standard_charge_percentage": 78.5000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 492.93, "standard_charge_percentage": 50.0000, "estimated_amount": 492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 295.76, "standard_charge_percentage": 30.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 837.98, "standard_charge_percentage": 85.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 766.16, "standard_charge_percentage": 78.5000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 735.21, "standard_charge_percentage": 78.5000, "estimated_amount": 735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 750.68, "standard_charge_percentage": 78.5000, "estimated_amount": 750, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 492.93, "standard_charge_percentage": 50.0000, "estimated_amount": 492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 591.52, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 887.27, "standard_charge_percentage": 90.0000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 750.68, "standard_charge_percentage": 78.5000, "estimated_amount": 750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 887.27, "standard_charge_percentage": 90.0000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 985.86, "standard_charge_percentage": 100.0000, "estimated_amount": 985, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 492.93, "standard_charge_percentage": 50.0000, "estimated_amount": 492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 696.51, "standard_charge_percentage": 78.5000, "estimated_amount": 696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 936.57, "standard_charge_percentage": 95.0000, "estimated_amount": 936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 739.39, "standard_charge_percentage": 75.0000, "estimated_amount": 739, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 788.69, "standard_charge_percentage": 80.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 773.9, "standard_charge_percentage": 78.5000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 773.9, "standard_charge_percentage": 78.5000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 985.86, "estimated_amount": 985, "methodology": "fee schedule" }]}]} , { "description": "MR GUIDE FNA BX ADDL LESION", "code_information": [ { "code": "11621", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2916.7, "discounted_cash": 821,"minimum": 243.24,"maximum": 2916.7,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1750.02, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2552.11, "standard_charge_percentage": 87.5000, "estimated_amount": 2552, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1155.01, "standard_charge_percentage": 39.6000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2187.53, "standard_charge_percentage": 75.0000, "estimated_amount": 2187, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2858.37, "standard_charge_percentage": 98.0000, "estimated_amount": 2858, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2289.61, "standard_charge_percentage": 78.5000, "estimated_amount": 2289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2625.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 875.01, "standard_charge_percentage": 30.0000, "estimated_amount": 875, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1604.18, "standard_charge_percentage": 55.0000, "estimated_amount": 1604, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2625.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2625, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2106.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2479.19, "standard_charge_percentage": 85.0000, "estimated_amount": 2479, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1458.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1458, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2625.03, "standard_charge_percentage": 90.0000, "estimated_amount": 2625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2770.86, "standard_charge_percentage": 95.0000, "estimated_amount": 2770, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2266.71, "standard_charge_percentage": 78.5000, "estimated_amount": 2266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2289.61, "standard_charge_percentage": 78.5000, "estimated_amount": 2289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1166.68, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2220.92, "standard_charge_percentage": 78.5000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2479.19, "standard_charge_percentage": 85.0000, "estimated_amount": 2479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2916.7, "standard_charge_percentage": 100.0000, "estimated_amount": 2916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2175.13, "standard_charge_percentage": 78.5000, "estimated_amount": 2175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2220.92, "standard_charge_percentage": 78.5000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2770.86, "standard_charge_percentage": 95.0000, "estimated_amount": 2770, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2175.13, "standard_charge_percentage": 78.5000, "estimated_amount": 2175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2060.65, "standard_charge_percentage": 78.5000, "estimated_amount": 2060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2289.61, "standard_charge_percentage": 78.5000, "estimated_amount": 2289, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1458.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1458, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1458.35, "standard_charge_percentage": 50.0000, "estimated_amount": 1458, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2220.92, "standard_charge_percentage": 78.5000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2220.92, "standard_charge_percentage": 78.5000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2220.92, "standard_charge_percentage": 78.5000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2333.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" }]}]} , { "description": "INJ CNT ARTHROGRAM KNEE CT/MRI", "code_information": [ { "code": "11622", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3882.13, "discounted_cash": 821,"minimum": 243.24,"maximum": 3882.13,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1552.85, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1552, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2911.6, "standard_charge_percentage": 75.0000, "estimated_amount": 2911, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3299.81, "standard_charge_percentage": 85.0000, "estimated_amount": 3299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3047.47, "standard_charge_percentage": 78.5000, "estimated_amount": 3047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2895.1, "standard_charge_percentage": 78.5000, "estimated_amount": 2895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2956.05, "standard_charge_percentage": 78.5000, "estimated_amount": 2956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2742.72, "standard_charge_percentage": 78.5000, "estimated_amount": 2742, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1164.64, "standard_charge_percentage": 30.0000, "estimated_amount": 1164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3493.92, "standard_charge_percentage": 90.0000, "estimated_amount": 3493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3688.02, "standard_charge_percentage": 95.0000, "estimated_amount": 3688, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1941.07, "standard_charge_percentage": 50.0000, "estimated_amount": 1941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3299.81, "standard_charge_percentage": 85.0000, "estimated_amount": 3299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3017, "standard_charge_percentage": 78.5000, "estimated_amount": 3017, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2895.1, "standard_charge_percentage": 78.5000, "estimated_amount": 2895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1941.07, "standard_charge_percentage": 50.0000, "estimated_amount": 1941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3688.02, "standard_charge_percentage": 95.0000, "estimated_amount": 3688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3493.92, "standard_charge_percentage": 90.0000, "estimated_amount": 3493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3882.13, "standard_charge_percentage": 100.0000, "estimated_amount": 3882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3396.86, "standard_charge_percentage": 87.5000, "estimated_amount": 3396, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1537.32, "standard_charge_percentage": 39.6000, "estimated_amount": 1537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3047.47, "standard_charge_percentage": 78.5000, "estimated_amount": 3047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2956.05, "standard_charge_percentage": 78.5000, "estimated_amount": 2956, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2956.05, "standard_charge_percentage": 78.5000, "estimated_amount": 2956, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1941.07, "standard_charge_percentage": 50.0000, "estimated_amount": 1941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2956.05, "standard_charge_percentage": 78.5000, "estimated_amount": 2956, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2803.67, "standard_charge_percentage": 78.5000, "estimated_amount": 2803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2956.05, "standard_charge_percentage": 78.5000, "estimated_amount": 2956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3047.47, "standard_charge_percentage": 78.5000, "estimated_amount": 3047, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3493.92, "standard_charge_percentage": 90.0000, "estimated_amount": 3493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2329.28, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2329, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2135.17, "standard_charge_percentage": 55.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3804.49, "standard_charge_percentage": 98.0000, "estimated_amount": 3804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3105.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3105, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" }]}]} , { "description": "Exc snhfg mal+mrg 2.1-3", "code_information": [ { "code": "11623", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4847.55, "discounted_cash": 1892,"minimum": 243.24,"maximum": 4847.55,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4241.61, "standard_charge_percentage": 87.5000, "estimated_amount": 4241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3691.17, "standard_charge_percentage": 78.5000, "estimated_amount": 3691, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4362.8, "standard_charge_percentage": 90.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4605.17, "standard_charge_percentage": 95.0000, "estimated_amount": 4605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2423.78, "standard_charge_percentage": 50.0000, "estimated_amount": 2423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3615.06, "standard_charge_percentage": 78.5000, "estimated_amount": 3615, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3691.17, "standard_charge_percentage": 78.5000, "estimated_amount": 3691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4847.55, "standard_charge_percentage": 100.0000, "estimated_amount": 4847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3615.06, "standard_charge_percentage": 78.5000, "estimated_amount": 3615, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3500.9, "standard_charge_percentage": 78.5000, "estimated_amount": 3500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3691.17, "standard_charge_percentage": 78.5000, "estimated_amount": 3691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4605.17, "standard_charge_percentage": 95.0000, "estimated_amount": 4605, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1919.63, "standard_charge_percentage": 39.6000, "estimated_amount": 1919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3424.79, "standard_charge_percentage": 78.5000, "estimated_amount": 3424, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4120.42, "standard_charge_percentage": 85.0000, "estimated_amount": 4120, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4362.8, "standard_charge_percentage": 90.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2666.15, "standard_charge_percentage": 55.0000, "estimated_amount": 2666, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4362.8, "standard_charge_percentage": 90.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3767.27, "standard_charge_percentage": 78.5000, "estimated_amount": 3767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3805.33, "standard_charge_percentage": 78.5000, "estimated_amount": 3805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3691.17, "standard_charge_percentage": 78.5000, "estimated_amount": 3691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3805.33, "standard_charge_percentage": 78.5000, "estimated_amount": 3805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3691.17, "standard_charge_percentage": 78.5000, "estimated_amount": 3691, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2423.78, "standard_charge_percentage": 50.0000, "estimated_amount": 2423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4750.6, "standard_charge_percentage": 98.0000, "estimated_amount": 4750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4120.42, "standard_charge_percentage": 85.0000, "estimated_amount": 4120, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2908.53, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3635.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1939.02, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1939, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2423.78, "standard_charge_percentage": 50.0000, "estimated_amount": 2423, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1454.27, "standard_charge_percentage": 30.0000, "estimated_amount": 1454, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3805.33, "standard_charge_percentage": 78.5000, "estimated_amount": 3805, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3878.04, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc s/n/h/f/g mal+mrg 3.1-4", "code_information": [ { "code": "11624", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 25122.6, "discounted_cash": 1892,"minimum": 243.24,"maximum": 25122.6,"payers_information":[{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 17749.1, "standard_charge_percentage": 78.5000, "estimated_amount": 17749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 18735.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18735, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 8939.12, "standard_charge_percentage": 98.0000, "estimated_amount": 8939, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 19721.2, "standard_charge_percentage": 78.5000, "estimated_amount": 19721, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 19129.6, "standard_charge_percentage": 78.5000, "estimated_amount": 19129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 13817.4, "standard_charge_percentage": 55.0000, "estimated_amount": 13817, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 19524, "standard_charge_percentage": 78.5000, "estimated_amount": 19524, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 22610.3, "standard_charge_percentage": 90.0000, "estimated_amount": 22610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 21982.3, "standard_charge_percentage": 87.5000, "estimated_amount": 21982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 7981.36, "standard_charge_percentage": 87.5000, "estimated_amount": 7981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6444.38, "standard_charge_percentage": 78.5000, "estimated_amount": 6444, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 19721.2, "standard_charge_percentage": 78.5000, "estimated_amount": 19721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 21354.2, "standard_charge_percentage": 85.0000, "estimated_amount": 21354, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 22610.3, "standard_charge_percentage": 90.0000, "estimated_amount": 22610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 19129.6, "standard_charge_percentage": 78.5000, "estimated_amount": 19129, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6587.58, "standard_charge_percentage": 78.5000, "estimated_amount": 6587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 8665.47, "standard_charge_percentage": 95.0000, "estimated_amount": 8665, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7753.32, "standard_charge_percentage": 85.0000, "estimated_amount": 7753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6802.4, "standard_charge_percentage": 78.5000, "estimated_amount": 6802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 18735.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7088.81, "standard_charge_percentage": 78.5000, "estimated_amount": 7088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 21354.2, "standard_charge_percentage": 85.0000, "estimated_amount": 21354, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 18143.5, "standard_charge_percentage": 78.5000, "estimated_amount": 18143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 23866.5, "standard_charge_percentage": 95.0000, "estimated_amount": 23866, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9948.55, "standard_charge_percentage": 39.6000, "estimated_amount": 9948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 18842, "standard_charge_percentage": 75.0000, "estimated_amount": 18841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9121.55, "standard_charge_percentage": 100.0000, "estimated_amount": 9121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 12561.3, "standard_charge_percentage": 50.0000, "estimated_amount": 12561, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6802.4, "standard_charge_percentage": 78.5000, "estimated_amount": 6802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 19129.6, "standard_charge_percentage": 78.5000, "estimated_amount": 19129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 22610.3, "standard_charge_percentage": 90.0000, "estimated_amount": 22610, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 19129.6, "standard_charge_percentage": 78.5000, "estimated_amount": 19129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 19129.6, "standard_charge_percentage": 78.5000, "estimated_amount": 19129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6841.16, "standard_charge_percentage": 75.0000, "estimated_amount": 6841, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 12561.3, "standard_charge_percentage": 50.0000, "estimated_amount": 12561, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3612.13, "standard_charge_percentage": 39.6000, "estimated_amount": 3612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3648.62, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5016.85, "standard_charge_percentage": 55.0000, "estimated_amount": 5016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 24620.2, "standard_charge_percentage": 98.0000, "estimated_amount": 24620, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2736.47, "standard_charge_percentage": 30.0000, "estimated_amount": 2736, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 19721.2, "standard_charge_percentage": 78.5000, "estimated_amount": 19721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 8665.47, "standard_charge_percentage": 95.0000, "estimated_amount": 8665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7753.32, "standard_charge_percentage": 85.0000, "estimated_amount": 7753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 12561.3, "standard_charge_percentage": 50.0000, "estimated_amount": 12561, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 23866.5, "standard_charge_percentage": 95.0000, "estimated_amount": 23866, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 25122.6, "standard_charge_percentage": 100.0000, "estimated_amount": 25122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 20098.1, "standard_charge_percentage": 80.0000, "estimated_amount": 20098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7536.78, "standard_charge_percentage": 30.0000, "estimated_amount": 7536, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" }]}]} , { "description": "Exc S/N/H/F/G Mal+Mrg >4 Cm", "code_information": [ { "code": "11626", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 22188.4, "discounted_cash": 3342,"minimum": 243.24,"maximum": 22188.4,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6444.38, "standard_charge_percentage": 78.5000, "estimated_amount": 6444, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 16641.3, "standard_charge_percentage": 75.0000, "estimated_amount": 16641, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 21744.6, "standard_charge_percentage": 98.0000, "estimated_amount": 21744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 8665.47, "standard_charge_percentage": 95.0000, "estimated_amount": 8665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6802.4, "standard_charge_percentage": 78.5000, "estimated_amount": 6802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6841.16, "standard_charge_percentage": 75.0000, "estimated_amount": 6841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7753.32, "standard_charge_percentage": 85.0000, "estimated_amount": 7753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 16547, "standard_charge_percentage": 78.5000, "estimated_amount": 16547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16024.5, "standard_charge_percentage": 78.5000, "estimated_amount": 16024, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6802.4, "standard_charge_percentage": 78.5000, "estimated_amount": 6802, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 7981.36, "standard_charge_percentage": 87.5000, "estimated_amount": 7981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2736.47, "standard_charge_percentage": 30.0000, "estimated_amount": 2736, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 18860.1, "standard_charge_percentage": 85.0000, "estimated_amount": 18860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 17243.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7088.81, "standard_charge_percentage": 78.5000, "estimated_amount": 7088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8786.61, "standard_charge_percentage": 39.6000, "estimated_amount": 8786, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 22188.4, "standard_charge_percentage": 100.0000, "estimated_amount": 22188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 21079, "standard_charge_percentage": 95.0000, "estimated_amount": 21078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 8939.12, "standard_charge_percentage": 98.0000, "estimated_amount": 8939, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21079, "standard_charge_percentage": 95.0000, "estimated_amount": 21078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 16547, "standard_charge_percentage": 78.5000, "estimated_amount": 16547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9121.55, "standard_charge_percentage": 100.0000, "estimated_amount": 9121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6656.52, "standard_charge_percentage": 30.0000, "estimated_amount": 6656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 19414.8, "standard_charge_percentage": 87.5000, "estimated_amount": 19414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7753.32, "standard_charge_percentage": 85.0000, "estimated_amount": 7753, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6587.58, "standard_charge_percentage": 78.5000, "estimated_amount": 6587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4560.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 18860.1, "standard_charge_percentage": 85.0000, "estimated_amount": 18860, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3612.13, "standard_charge_percentage": 39.6000, "estimated_amount": 3612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12203.6, "standard_charge_percentage": 55.0000, "estimated_amount": 12203, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3648.62, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3648, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5016.85, "standard_charge_percentage": 55.0000, "estimated_amount": 5016, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7160.42, "standard_charge_percentage": 78.5000, "estimated_amount": 7160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8209.39, "standard_charge_percentage": 90.0000, "estimated_amount": 8209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 15676.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 8665.47, "standard_charge_percentage": 95.0000, "estimated_amount": 8665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6945.6, "standard_charge_percentage": 78.5000, "estimated_amount": 6945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7297.24, "standard_charge_percentage": 80.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11642", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 24573.1, "discounted_cash": 821,"minimum": 243.24,"maximum": 24573.1,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 23344.4, "standard_charge_percentage": 95.0000, "estimated_amount": 23344, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 12286.5, "standard_charge_percentage": 50.0000, "estimated_amount": 12286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 23344.4, "standard_charge_percentage": 95.0000, "estimated_amount": 23344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 17360.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 19289.9, "standard_charge_percentage": 78.5000, "estimated_amount": 19289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7371.92, "standard_charge_percentage": 30.0000, "estimated_amount": 7371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 20887.1, "standard_charge_percentage": 85.0000, "estimated_amount": 20887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 22115.8, "standard_charge_percentage": 90.0000, "estimated_amount": 22115, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 24081.6, "standard_charge_percentage": 98.0000, "estimated_amount": 24081, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 18325.4, "standard_charge_percentage": 78.5000, "estimated_amount": 18325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 18325.4, "standard_charge_percentage": 78.5000, "estimated_amount": 18325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 12286.5, "standard_charge_percentage": 50.0000, "estimated_amount": 12286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 24573.1, "standard_charge_percentage": 100.0000, "estimated_amount": 24573, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 19289.9, "standard_charge_percentage": 78.5000, "estimated_amount": 19289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 17746.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17746, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 22115.8, "standard_charge_percentage": 90.0000, "estimated_amount": 22115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 18429.8, "standard_charge_percentage": 75.0000, "estimated_amount": 18429, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 12286.5, "standard_charge_percentage": 50.0000, "estimated_amount": 12286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 13515.2, "standard_charge_percentage": 55.0000, "estimated_amount": 13515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 21501.4, "standard_charge_percentage": 87.5000, "estimated_amount": 21501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 22115.8, "standard_charge_percentage": 90.0000, "estimated_amount": 22115, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 19289.9, "standard_charge_percentage": 78.5000, "estimated_amount": 19289, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 20887.1, "standard_charge_percentage": 85.0000, "estimated_amount": 20887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 19097, "standard_charge_percentage": 78.5000, "estimated_amount": 19096, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9730.94, "standard_charge_percentage": 39.6000, "estimated_amount": 9730, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11643", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 23042.4, "discounted_cash": 1892,"minimum": 243.24,"maximum": 23042.4,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9124.8, "standard_charge_percentage": 39.6000, "estimated_amount": 9124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12673.3, "standard_charge_percentage": 55.0000, "estimated_amount": 12673, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 20738.2, "standard_charge_percentage": 90.0000, "estimated_amount": 20738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 18088.3, "standard_charge_percentage": 78.5000, "estimated_amount": 18088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 18088.3, "standard_charge_percentage": 78.5000, "estimated_amount": 18088, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 22581.6, "standard_charge_percentage": 98.0000, "estimated_amount": 22581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 20738.2, "standard_charge_percentage": 90.0000, "estimated_amount": 20738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 19586.1, "standard_charge_percentage": 85.0000, "estimated_amount": 19586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 18088.3, "standard_charge_percentage": 78.5000, "estimated_amount": 18088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6912.73, "standard_charge_percentage": 30.0000, "estimated_amount": 6912, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 20738.2, "standard_charge_percentage": 90.0000, "estimated_amount": 20738, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 19586.1, "standard_charge_percentage": 85.0000, "estimated_amount": 19586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 16279.5, "standard_charge_percentage": 78.5000, "estimated_amount": 16279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 20162.1, "standard_charge_percentage": 87.5000, "estimated_amount": 20162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 17545.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 23042.4, "standard_charge_percentage": 100.0000, "estimated_amount": 23042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 17183.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 17907.4, "standard_charge_percentage": 78.5000, "estimated_amount": 17907, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21890.3, "standard_charge_percentage": 95.0000, "estimated_amount": 21890, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11521.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17281.8, "standard_charge_percentage": 75.0000, "estimated_amount": 17281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 21890.3, "standard_charge_percentage": 95.0000, "estimated_amount": 21890, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 17545.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17545, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11521.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11521.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11521, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16641.2, "standard_charge_percentage": 78.5000, "estimated_amount": 16641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 17545.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 18433.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 17545.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 17183.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17183, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 17545.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17545, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11644", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5717.88, "discounted_cash": 1892,"minimum": 243.24,"maximum": 5717.88,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2858.94, "standard_charge_percentage": 50.0000, "estimated_amount": 2858, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4353.88, "standard_charge_percentage": 78.5000, "estimated_amount": 4353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5146.09, "standard_charge_percentage": 90.0000, "estimated_amount": 5146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2287.15, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2287, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2858.94, "standard_charge_percentage": 50.0000, "estimated_amount": 2858, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2264.28, "standard_charge_percentage": 39.6000, "estimated_amount": 2264, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4353.88, "standard_charge_percentage": 78.5000, "estimated_amount": 4353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5003.15, "standard_charge_percentage": 87.5000, "estimated_amount": 5003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5146.09, "standard_charge_percentage": 90.0000, "estimated_amount": 5146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3430.73, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3430, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2858.94, "standard_charge_percentage": 50.0000, "estimated_amount": 2858, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5146.09, "standard_charge_percentage": 90.0000, "estimated_amount": 5146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5431.99, "standard_charge_percentage": 95.0000, "estimated_amount": 5431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4039.68, "standard_charge_percentage": 78.5000, "estimated_amount": 4039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5431.99, "standard_charge_percentage": 95.0000, "estimated_amount": 5431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4488.54, "standard_charge_percentage": 78.5000, "estimated_amount": 4488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4288.41, "standard_charge_percentage": 75.0000, "estimated_amount": 4288, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1715.36, "standard_charge_percentage": 30.0000, "estimated_amount": 1715, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4860.2, "standard_charge_percentage": 85.0000, "estimated_amount": 4860, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4129.45, "standard_charge_percentage": 78.5000, "estimated_amount": 4129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4353.88, "standard_charge_percentage": 78.5000, "estimated_amount": 4353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3144.83, "standard_charge_percentage": 55.0000, "estimated_amount": 3144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4353.88, "standard_charge_percentage": 78.5000, "estimated_amount": 4353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4264.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4443.65, "standard_charge_percentage": 78.5000, "estimated_amount": 4443, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5603.52, "standard_charge_percentage": 98.0000, "estimated_amount": 5603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4574.3, "standard_charge_percentage": 80.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4264.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4488.54, "standard_charge_percentage": 78.5000, "estimated_amount": 4488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4353.88, "standard_charge_percentage": 78.5000, "estimated_amount": 4353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4860.2, "standard_charge_percentage": 85.0000, "estimated_amount": 4860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4488.54, "standard_charge_percentage": 78.5000, "estimated_amount": 4488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 5717.88, "standard_charge_percentage": 100.0000, "estimated_amount": 5717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" }]}]} , { "description": "Trim nail(s) any number", "code_information": [ { "code": "11719", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 337.93, "discounted_cash": 69,"minimum": 50.69,"maximum": 337.93,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 83.66, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 257.32, "standard_charge_percentage": 78.5000, "estimated_amount": 257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 82.71, "estimated_amount": 82, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 265.28, "standard_charge_percentage": 78.5000, "estimated_amount": 265, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 133.82, "standard_charge_percentage": 39.6000, "estimated_amount": 133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 253.45, "standard_charge_percentage": 75.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 74.7, "estimated_amount": 74, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 257.32, "standard_charge_percentage": 78.5000, "estimated_amount": 257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 238.75, "standard_charge_percentage": 78.5000, "estimated_amount": 238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 287.24, "standard_charge_percentage": 85.0000, "estimated_amount": 287, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 262.62, "standard_charge_percentage": 78.5000, "estimated_amount": 262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 265.28, "standard_charge_percentage": 78.5000, "estimated_amount": 265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 257.32, "standard_charge_percentage": 78.5000, "estimated_amount": 257, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 331.17, "standard_charge_percentage": 98.0000, "estimated_amount": 331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 101.38, "standard_charge_percentage": 30.0000, "estimated_amount": 101, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 252.01, "standard_charge_percentage": 78.5000, "estimated_amount": 252, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 257.32, "standard_charge_percentage": 78.5000, "estimated_amount": 257, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 168.97, "standard_charge_percentage": 50.0000, "estimated_amount": 168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 304.14, "standard_charge_percentage": 90.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 168.97, "standard_charge_percentage": 50.0000, "estimated_amount": 168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 257.32, "standard_charge_percentage": 78.5000, "estimated_amount": 257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 168.97, "standard_charge_percentage": 50.0000, "estimated_amount": 168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 54.43, "estimated_amount": 54, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 53.89, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 295.69, "standard_charge_percentage": 87.5000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 287.24, "standard_charge_percentage": 85.0000, "estimated_amount": 287, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 82.71, "estimated_amount": 82, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 106.72, "estimated_amount": 106, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 304.14, "standard_charge_percentage": 90.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 185.86, "standard_charge_percentage": 55.0000, "estimated_amount": 185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 202.76, "standard_charge_percentage": 60.0000, "estimated_amount": 202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 150.04, "standard_charge_percentage": 44.4000, "estimated_amount": 150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 337.93, "standard_charge_percentage": 100.0000, "estimated_amount": 337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 52.83, "estimated_amount": 52, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 252.01, "standard_charge_percentage": 78.5000, "estimated_amount": 252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 321.03, "standard_charge_percentage": 95.0000, "estimated_amount": 321, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 244.05, "standard_charge_percentage": 78.5000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 304.14, "standard_charge_percentage": 90.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 265.28, "standard_charge_percentage": 78.5000, "estimated_amount": 265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 50.69, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 270.34, "standard_charge_percentage": 80.0000, "estimated_amount": 270, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 337.93, "estimated_amount": 337, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 321.03, "standard_charge_percentage": 95.0000, "estimated_amount": 321, "methodology": "percent of total billed charges" }]}]} , { "description": "Debride nail 1-5", "code_information": [ { "code": "11720", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 869.26, "discounted_cash": 69,"minimum": 50.69,"maximum": 869.26,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 106.72, "estimated_amount": 106, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 344.23, "standard_charge_percentage": 39.6000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 74.7, "estimated_amount": 74, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 738.87, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 825.8, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 478.09, "standard_charge_percentage": 55.0000, "estimated_amount": 478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 83.66, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 738.87, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 260.78, "standard_charge_percentage": 30.0000, "estimated_amount": 260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 825.8, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 82.71, "estimated_amount": 82, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 82.71, "estimated_amount": 82, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 54.43, "estimated_amount": 54, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 614.13, "standard_charge_percentage": 78.5000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 648.25, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 675.55, "standard_charge_percentage": 78.5000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 347.7, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 53.89, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 521.56, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 869.26, "standard_charge_percentage": 100.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 648.25, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 760.6, "standard_charge_percentage": 87.5000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 651.95, "standard_charge_percentage": 75.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 851.87, "standard_charge_percentage": 98.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 627.78, "standard_charge_percentage": 78.5000, "estimated_amount": 627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 52.83, "estimated_amount": 52, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 50.69, "estimated_amount": 50, "methodology": "fee schedule" }]}]} , { "description": "Hc Debridement Of Nails, 6 Or More", "code_information": [ { "code": "11721", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 848.06, "discounted_cash": 69,"minimum": 50.69,"maximum": 848.06,"payers_information":[{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 466.43, "standard_charge_percentage": 55.0000, "estimated_amount": 466, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 52.83, "estimated_amount": 52, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 805.66, "standard_charge_percentage": 95.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 632.44, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 665.73, "standard_charge_percentage": 78.5000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 665.73, "standard_charge_percentage": 78.5000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 599.15, "standard_charge_percentage": 78.5000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 636.04, "standard_charge_percentage": 75.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 82.71, "estimated_amount": 82, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 659.07, "standard_charge_percentage": 78.5000, "estimated_amount": 659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 54.43, "estimated_amount": 54, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 805.66, "standard_charge_percentage": 95.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 106.72, "estimated_amount": 106, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 53.89, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 612.47, "standard_charge_percentage": 78.5000, "estimated_amount": 612, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 763.25, "standard_charge_percentage": 90.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 665.73, "standard_charge_percentage": 78.5000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 424.03, "standard_charge_percentage": 50.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 74.7, "estimated_amount": 74, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 424.03, "standard_charge_percentage": 50.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 720.85, "standard_charge_percentage": 85.0000, "estimated_amount": 720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 720.85, "standard_charge_percentage": 85.0000, "estimated_amount": 720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 508.84, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 508, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 848.06, "standard_charge_percentage": 100.0000, "estimated_amount": 848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 742.05, "standard_charge_percentage": 87.5000, "estimated_amount": 742, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 254.42, "standard_charge_percentage": 30.0000, "estimated_amount": 254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 82.71, "estimated_amount": 82, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 335.83, "standard_charge_percentage": 39.6000, "estimated_amount": 335, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 763.25, "standard_charge_percentage": 90.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 339.22, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 424.03, "standard_charge_percentage": 50.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 83.66, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 53.36, "estimated_amount": 53, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 831.1, "standard_charge_percentage": 98.0000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 632.44, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 50.69, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 763.25, "standard_charge_percentage": 90.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Removal Of Nail Plate", "code_information": [ { "code": "11730", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 869.26, "discounted_cash": 232,"minimum": 83.66,"maximum": 19634.1,"payers_information":[{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19241.4, "standard_charge_percentage": 98.0000, "estimated_amount": 19241, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 344.23, "standard_charge_percentage": 39.6000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10798.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17179.8, "standard_charge_percentage": 87.5000, "estimated_amount": 17179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16689, "standard_charge_percentage": 85.0000, "estimated_amount": 16688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14642.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 648.25, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14725.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 675.55, "standard_charge_percentage": 78.5000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14179.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18652.4, "standard_charge_percentage": 95.0000, "estimated_amount": 18652, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 869.26, "standard_charge_percentage": 100.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 648.25, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14642.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 738.87, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 738.87, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 651.95, "standard_charge_percentage": 75.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 521.56, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 627.78, "standard_charge_percentage": 78.5000, "estimated_amount": 627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7775.1, "standard_charge_percentage": 39.6000, "estimated_amount": 7775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 478.09, "standard_charge_percentage": 55.0000, "estimated_amount": 478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18652.4, "standard_charge_percentage": 95.0000, "estimated_amount": 18652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13871.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 825.8, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15258.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 760.6, "standard_charge_percentage": 87.5000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16689, "standard_charge_percentage": 85.0000, "estimated_amount": 16688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19634.1, "standard_charge_percentage": 100.0000, "estimated_amount": 19634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5890.23, "standard_charge_percentage": 30.0000, "estimated_amount": 5890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 825.8, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 347.7, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 260.78, "standard_charge_percentage": 30.0000, "estimated_amount": 260, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 851.87, "standard_charge_percentage": 98.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 83.66, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 614.13, "standard_charge_percentage": 78.5000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Removal Of Nail Plate, Simple, Ea Ad", "code_information": [ { "code": "11732", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 851.27,"minimum": 83.66,"maximum": 851.27,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 648.2, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 614.79, "standard_charge_percentage": 78.5000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 425.63, "standard_charge_percentage": 50.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 425.63, "standard_charge_percentage": 50.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 766.14, "standard_charge_percentage": 90.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 425.63, "standard_charge_percentage": 50.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 638.45, "standard_charge_percentage": 75.0000, "estimated_amount": 638, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 337.1, "standard_charge_percentage": 39.6000, "estimated_amount": 337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 723.58, "standard_charge_percentage": 85.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 601.42, "standard_charge_percentage": 78.5000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 723.58, "standard_charge_percentage": 85.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 766.14, "standard_charge_percentage": 90.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 668.25, "standard_charge_percentage": 78.5000, "estimated_amount": 668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 661.56, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 851.27, "standard_charge_percentage": 100.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 808.71, "standard_charge_percentage": 95.0000, "estimated_amount": 808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 668.25, "standard_charge_percentage": 78.5000, "estimated_amount": 668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 255.38, "standard_charge_percentage": 30.0000, "estimated_amount": 255, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 648.2, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 648.2, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 766.14, "standard_charge_percentage": 90.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 634.83, "standard_charge_percentage": 78.5000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 808.71, "standard_charge_percentage": 95.0000, "estimated_amount": 808, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 510.76, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 634.83, "standard_charge_percentage": 78.5000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 681.02, "standard_charge_percentage": 80.0000, "estimated_amount": 681, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 648.2, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 468.2, "standard_charge_percentage": 55.0000, "estimated_amount": 468, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 340.51, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 340, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 834.24, "standard_charge_percentage": 98.0000, "estimated_amount": 834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 744.86, "standard_charge_percentage": 87.5000, "estimated_amount": 744, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 83.66, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 648.2, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 668.25, "standard_charge_percentage": 78.5000, "estimated_amount": 668, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Drain Blood From Under Nail", "code_information": [ { "code": "11740", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 860.71, "discounted_cash": 150,"minimum": 83.66,"maximum": 860.71,"payers_information":[{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 731.6, "standard_charge_percentage": 85.0000, "estimated_amount": 731, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 114.64, "estimated_amount": 114, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 655.39, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 774.64, "standard_charge_percentage": 90.0000, "estimated_amount": 774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 258.21, "standard_charge_percentage": 30.0000, "estimated_amount": 258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 668.9, "standard_charge_percentage": 78.5000, "estimated_amount": 668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 473.39, "standard_charge_percentage": 55.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 430.36, "standard_charge_percentage": 50.0000, "estimated_amount": 430, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 843.5, "standard_charge_percentage": 98.0000, "estimated_amount": 843, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 621.6, "standard_charge_percentage": 78.5000, "estimated_amount": 621, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 516.43, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 344.28, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 118.12, "estimated_amount": 118, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 655.39, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 645.53, "standard_charge_percentage": 75.0000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 774.64, "standard_charge_percentage": 90.0000, "estimated_amount": 774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 860.71, "standard_charge_percentage": 100.0000, "estimated_amount": 860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 817.67, "standard_charge_percentage": 95.0000, "estimated_amount": 817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 231.6, "estimated_amount": 231, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 179.49, "estimated_amount": 179, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 655.39, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 430.36, "standard_charge_percentage": 50.0000, "estimated_amount": 430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 110.01, "estimated_amount": 110, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 162.12, "estimated_amount": 162, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 675.66, "standard_charge_percentage": 78.5000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 817.67, "standard_charge_percentage": 95.0000, "estimated_amount": 817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 116.96, "estimated_amount": 116, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 430.36, "standard_charge_percentage": 50.0000, "estimated_amount": 430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 608.09, "standard_charge_percentage": 78.5000, "estimated_amount": 608, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 340.84, "standard_charge_percentage": 39.6000, "estimated_amount": 340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 675.66, "standard_charge_percentage": 78.5000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 731.6, "standard_charge_percentage": 85.0000, "estimated_amount": 731, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 655.39, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 774.64, "standard_charge_percentage": 90.0000, "estimated_amount": 774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 641.87, "standard_charge_percentage": 78.5000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 179.49, "estimated_amount": 179, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 688.57, "standard_charge_percentage": 80.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 641.87, "standard_charge_percentage": 78.5000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 83.66, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 655.39, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 753.12, "standard_charge_percentage": 87.5000, "estimated_amount": 753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 675.66, "standard_charge_percentage": 78.5000, "estimated_amount": 675, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Removal Of Nail Bed", "code_information": [ { "code": "11750", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4002.66, "discounted_cash": 466,"minimum": 243.24,"maximum": 20014,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3602.39, "standard_charge_percentage": 90.0000, "estimated_amount": 3602, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14139.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15553.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 19013.3, "standard_charge_percentage": 95.0000, "estimated_amount": 19013, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3001.99, "standard_charge_percentage": 75.0000, "estimated_amount": 3001, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3802.53, "standard_charge_percentage": 95.0000, "estimated_amount": 3802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2001.33, "standard_charge_percentage": 50.0000, "estimated_amount": 2001, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3047.83, "standard_charge_percentage": 78.5000, "estimated_amount": 3047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3047.83, "standard_charge_percentage": 78.5000, "estimated_amount": 3047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3402.26, "standard_charge_percentage": 85.0000, "estimated_amount": 3402, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1585.05, "standard_charge_percentage": 39.6000, "estimated_amount": 1585, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3047.83, "standard_charge_percentage": 78.5000, "estimated_amount": 3047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19613.7, "standard_charge_percentage": 98.0000, "estimated_amount": 19613, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14925.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 17011.9, "standard_charge_percentage": 85.0000, "estimated_amount": 17011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2890.72, "standard_charge_percentage": 78.5000, "estimated_amount": 2890, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2827.88, "standard_charge_percentage": 78.5000, "estimated_amount": 2827, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2001.33, "standard_charge_percentage": 50.0000, "estimated_amount": 2001, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3047.83, "standard_charge_percentage": 78.5000, "estimated_amount": 3047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2984.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2984, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3110.67, "standard_charge_percentage": 78.5000, "estimated_amount": 3110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2401.6, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2401, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17512.3, "standard_charge_percentage": 87.5000, "estimated_amount": 17512, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 17011.9, "standard_charge_percentage": 85.0000, "estimated_amount": 17011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3142.09, "standard_charge_percentage": 78.5000, "estimated_amount": 3142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4002.66, "standard_charge_percentage": 100.0000, "estimated_amount": 4002, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3602.39, "standard_charge_percentage": 90.0000, "estimated_amount": 3602, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2984.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2984, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2001.33, "standard_charge_percentage": 50.0000, "estimated_amount": 2001, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3602.39, "standard_charge_percentage": 90.0000, "estimated_amount": 3602, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 19013.3, "standard_charge_percentage": 95.0000, "estimated_amount": 19013, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14925.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3402.26, "standard_charge_percentage": 85.0000, "estimated_amount": 3402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6004.2, "standard_charge_percentage": 30.0000, "estimated_amount": 6004, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11007.7, "standard_charge_percentage": 55.0000, "estimated_amount": 11007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7925.54, "standard_charge_percentage": 39.6000, "estimated_amount": 7925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3802.53, "standard_charge_percentage": 95.0000, "estimated_amount": 3802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3502.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3502, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3142.09, "standard_charge_percentage": 78.5000, "estimated_amount": 3142, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1601.06, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3142.09, "standard_charge_percentage": 78.5000, "estimated_amount": 3142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3047.83, "standard_charge_percentage": 78.5000, "estimated_amount": 3047, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3922.61, "standard_charge_percentage": 98.0000, "estimated_amount": 3922, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14454.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 20014, "standard_charge_percentage": 100.0000, "estimated_amount": 20014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 15010.5, "standard_charge_percentage": 75.0000, "estimated_amount": 15010, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1200.8, "standard_charge_percentage": 30.0000, "estimated_amount": 1200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3202.13, "standard_charge_percentage": 80.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2201.46, "standard_charge_percentage": 55.0000, "estimated_amount": 2201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" }]}]} , { "description": "Hc Biopsy, Nail Unit (Sep Proc)", "code_information": [ { "code": "11755", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 995.19, "discounted_cash": 821,"minimum": 298.56,"maximum": 995.19,"payers_information":[{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 547.35, "standard_charge_percentage": 55.0000, "estimated_amount": 547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 757.79, "standard_charge_percentage": 78.5000, "estimated_amount": 757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 870.79, "standard_charge_percentage": 87.5000, "estimated_amount": 870, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 757.79, "standard_charge_percentage": 78.5000, "estimated_amount": 757, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 718.73, "standard_charge_percentage": 78.5000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 597.11, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 945.43, "standard_charge_percentage": 95.0000, "estimated_amount": 945, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 497.6, "standard_charge_percentage": 50.0000, "estimated_amount": 497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 895.67, "standard_charge_percentage": 90.0000, "estimated_amount": 895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 757.79, "standard_charge_percentage": 78.5000, "estimated_amount": 757, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 773.41, "standard_charge_percentage": 78.5000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 497.6, "standard_charge_percentage": 50.0000, "estimated_amount": 497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 781.22, "standard_charge_percentage": 78.5000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 895.67, "standard_charge_percentage": 90.0000, "estimated_amount": 895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 781.22, "standard_charge_percentage": 78.5000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 945.43, "standard_charge_percentage": 95.0000, "estimated_amount": 945, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 845.91, "standard_charge_percentage": 85.0000, "estimated_amount": 845, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 298.56, "standard_charge_percentage": 30.0000, "estimated_amount": 298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 845.91, "standard_charge_percentage": 85.0000, "estimated_amount": 845, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 975.29, "standard_charge_percentage": 98.0000, "estimated_amount": 975, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 703.1, "standard_charge_percentage": 78.5000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 796.15, "standard_charge_percentage": 80.0000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 995.19, "standard_charge_percentage": 100.0000, "estimated_amount": 995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 742.16, "standard_charge_percentage": 78.5000, "estimated_amount": 742, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 398.08, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 781.22, "standard_charge_percentage": 78.5000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 394.1, "standard_charge_percentage": 39.6000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 995.19, "estimated_amount": 995, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 497.6, "standard_charge_percentage": 50.0000, "estimated_amount": 497, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 757.79, "standard_charge_percentage": 78.5000, "estimated_amount": 757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 757.79, "standard_charge_percentage": 78.5000, "estimated_amount": 757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 742.16, "standard_charge_percentage": 78.5000, "estimated_amount": 742, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 895.67, "standard_charge_percentage": 90.0000, "estimated_amount": 895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 746.39, "standard_charge_percentage": 75.0000, "estimated_amount": 746, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" }]}]} , { "description": "Repair of nail bed", "code_information": [ { "code": "11760", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2645.85, "discounted_cash": 714,"minimum": 83.66,"maximum": 28056.9,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 83.66, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 19822.2, "standard_charge_percentage": 78.5000, "estimated_amount": 19822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 25251.2, "standard_charge_percentage": 90.0000, "estimated_amount": 25251, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 14028.5, "standard_charge_percentage": 50.0000, "estimated_amount": 14028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 24549.8, "standard_charge_percentage": 87.5000, "estimated_amount": 24549, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2513.56, "standard_charge_percentage": 95.0000, "estimated_amount": 2513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1058.34, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2513.56, "standard_charge_percentage": 95.0000, "estimated_amount": 2513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 22024.7, "standard_charge_percentage": 78.5000, "estimated_amount": 22024, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1973.14, "standard_charge_percentage": 78.5000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 8417.07, "standard_charge_percentage": 30.0000, "estimated_amount": 8417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 21363.9, "standard_charge_percentage": 78.5000, "estimated_amount": 21363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2315.12, "standard_charge_percentage": 87.5000, "estimated_amount": 2315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2248.97, "standard_charge_percentage": 85.0000, "estimated_amount": 2248, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 20923.4, "standard_charge_percentage": 78.5000, "estimated_amount": 20923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1047.76, "standard_charge_percentage": 39.6000, "estimated_amount": 1047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2056.22, "standard_charge_percentage": 78.5000, "estimated_amount": 2056, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2592.93, "standard_charge_percentage": 98.0000, "estimated_amount": 2592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1587.51, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1455.22, "standard_charge_percentage": 55.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1984.39, "standard_charge_percentage": 75.0000, "estimated_amount": 1984, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 22024.7, "standard_charge_percentage": 78.5000, "estimated_amount": 22024, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 27495.8, "standard_charge_percentage": 98.0000, "estimated_amount": 27495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1910.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1910, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 25251.2, "standard_charge_percentage": 90.0000, "estimated_amount": 25251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2248.97, "standard_charge_percentage": 85.0000, "estimated_amount": 2248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 28056.9, "standard_charge_percentage": 100.0000, "estimated_amount": 28056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1869.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 14028.5, "standard_charge_percentage": 50.0000, "estimated_amount": 14028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 11110.5, "standard_charge_percentage": 39.6000, "estimated_amount": 11110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 25251.2, "standard_charge_percentage": 90.0000, "estimated_amount": 25251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2645.85, "standard_charge_percentage": 100.0000, "estimated_amount": 2645, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 20262.7, "standard_charge_percentage": 78.5000, "estimated_amount": 20262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 20923.4, "standard_charge_percentage": 78.5000, "estimated_amount": 20923, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 23848.4, "standard_charge_percentage": 85.0000, "estimated_amount": 23848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 14028.5, "standard_charge_percentage": 50.0000, "estimated_amount": 14028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 21042.7, "standard_charge_percentage": 75.0000, "estimated_amount": 21042, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 793.75, "standard_charge_percentage": 30.0000, "estimated_amount": 793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 21363.9, "standard_charge_percentage": 78.5000, "estimated_amount": 21363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 21363.9, "standard_charge_percentage": 78.5000, "estimated_amount": 21363, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 26654.1, "standard_charge_percentage": 95.0000, "estimated_amount": 26654, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 15431.3, "standard_charge_percentage": 55.0000, "estimated_amount": 15431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 22024.7, "standard_charge_percentage": 78.5000, "estimated_amount": 22024, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 22445.5, "standard_charge_percentage": 80.0000, "estimated_amount": 22445, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 21804.4, "standard_charge_percentage": 78.5000, "estimated_amount": 21804, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 21363.9, "standard_charge_percentage": 78.5000, "estimated_amount": 21363, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 21363.9, "standard_charge_percentage": 78.5000, "estimated_amount": 21363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 23848.4, "standard_charge_percentage": 85.0000, "estimated_amount": 23848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 26654.1, "standard_charge_percentage": 95.0000, "estimated_amount": 26654, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1973.14, "standard_charge_percentage": 78.5000, "estimated_amount": 1973, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Excision Of Nail Fold (Wedge), Toe", "code_information": [ { "code": "11765", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 83.66,"maximum": 1679.85,"payers_information":[{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 83.66, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" }]}]} , { "description": "Remove pilonidal cyst simple", "code_information": [ { "code": "11770", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4731.97, "discounted_cash": 3342,"minimum": 374.23,"maximum": 4731.97,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3343.14, "standard_charge_percentage": 78.5000, "estimated_amount": 3343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4258.77, "standard_charge_percentage": 90.0000, "estimated_amount": 4258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3714.6, "standard_charge_percentage": 78.5000, "estimated_amount": 3714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3548.98, "standard_charge_percentage": 75.0000, "estimated_amount": 3548, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4637.33, "standard_charge_percentage": 98.0000, "estimated_amount": 4637, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3603.16, "standard_charge_percentage": 78.5000, "estimated_amount": 3603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2365.99, "standard_charge_percentage": 50.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3528.87, "standard_charge_percentage": 78.5000, "estimated_amount": 3528, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4495.37, "standard_charge_percentage": 95.0000, "estimated_amount": 4495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2839.18, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4258.77, "standard_charge_percentage": 90.0000, "estimated_amount": 4258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2602.58, "standard_charge_percentage": 55.0000, "estimated_amount": 2602, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4022.17, "standard_charge_percentage": 85.0000, "estimated_amount": 4022, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4258.77, "standard_charge_percentage": 90.0000, "estimated_amount": 4258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4495.37, "standard_charge_percentage": 95.0000, "estimated_amount": 4495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1892.79, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1892, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3603.16, "standard_charge_percentage": 78.5000, "estimated_amount": 3603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3528.87, "standard_charge_percentage": 78.5000, "estimated_amount": 3528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3603.16, "standard_charge_percentage": 78.5000, "estimated_amount": 3603, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2365.99, "standard_charge_percentage": 50.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3677.45, "standard_charge_percentage": 78.5000, "estimated_amount": 3677, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4022.17, "standard_charge_percentage": 85.0000, "estimated_amount": 4022, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1873.86, "standard_charge_percentage": 39.6000, "estimated_amount": 1873, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3603.16, "standard_charge_percentage": 78.5000, "estimated_amount": 3603, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3714.6, "standard_charge_percentage": 78.5000, "estimated_amount": 3714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4140.47, "standard_charge_percentage": 87.5000, "estimated_amount": 4140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 4731.97, "estimated_amount": 4731, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4731.97, "standard_charge_percentage": 100.0000, "estimated_amount": 4731, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3417.43, "standard_charge_percentage": 78.5000, "estimated_amount": 3417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3785.58, "standard_charge_percentage": 80.0000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3603.16, "standard_charge_percentage": 78.5000, "estimated_amount": 3603, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2365.99, "standard_charge_percentage": 50.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3714.6, "standard_charge_percentage": 78.5000, "estimated_amount": 3714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1419.59, "standard_charge_percentage": 30.0000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" }]}]} , { "description": "Remove pilonidal cyst exten", "code_information": [ { "code": "11771", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20918.4, "discounted_cash": 3342,"minimum": 374.23,"maximum": 20918.4,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8283.69, "standard_charge_percentage": 39.6000, "estimated_amount": 8283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 16256.7, "standard_charge_percentage": 78.5000, "estimated_amount": 16256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 20500, "standard_charge_percentage": 98.0000, "estimated_amount": 20500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 17780.6, "standard_charge_percentage": 85.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 15599.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10459.2, "standard_charge_percentage": 50.0000, "estimated_amount": 10459, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 19872.5, "standard_charge_percentage": 95.0000, "estimated_amount": 19872, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10459.2, "standard_charge_percentage": 50.0000, "estimated_amount": 10459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 17780.6, "standard_charge_percentage": 85.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 18303.6, "standard_charge_percentage": 87.5000, "estimated_amount": 18303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 15688.8, "standard_charge_percentage": 75.0000, "estimated_amount": 15688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10459.2, "standard_charge_percentage": 50.0000, "estimated_amount": 10459, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11505.1, "standard_charge_percentage": 55.0000, "estimated_amount": 11505, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6275.52, "standard_charge_percentage": 30.0000, "estimated_amount": 6275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14778.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 18826.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15928.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15928, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16420.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15928.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15928.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 18826.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 15599.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15599, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 15107.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 16420.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 20918.4, "standard_charge_percentage": 100.0000, "estimated_amount": 20918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 18826.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16734.7, "standard_charge_percentage": 80.0000, "estimated_amount": 16734, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15928.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 19872.5, "standard_charge_percentage": 95.0000, "estimated_amount": 19872, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 16420.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15928.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15928, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Excision Pilonidal Cyst/Sinus Complicated", "code_information": [ { "code": "11772", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 11624, "discounted_cash": 3342,"minimum": 374.23,"maximum": 11624,"payers_information":[{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3487.2, "standard_charge_percentage": 30.0000, "estimated_amount": 3487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 10461.6, "standard_charge_percentage": 90.0000, "estimated_amount": 10461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 9880.4, "standard_charge_percentage": 85.0000, "estimated_amount": 9880, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 5812, "standard_charge_percentage": 50.0000, "estimated_amount": 5812, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 11042.8, "standard_charge_percentage": 95.0000, "estimated_amount": 11042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9124.84, "standard_charge_percentage": 78.5000, "estimated_amount": 9124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 11391.5, "standard_charge_percentage": 98.0000, "estimated_amount": 11391, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 8394.85, "standard_charge_percentage": 78.5000, "estimated_amount": 8394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 8851.09, "standard_charge_percentage": 78.5000, "estimated_amount": 8851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 8668.6, "standard_charge_percentage": 78.5000, "estimated_amount": 8668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 8851.09, "standard_charge_percentage": 78.5000, "estimated_amount": 8851, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 9880.4, "standard_charge_percentage": 85.0000, "estimated_amount": 9880, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 6393.2, "standard_charge_percentage": 55.0000, "estimated_amount": 6393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 10461.6, "standard_charge_percentage": 90.0000, "estimated_amount": 10461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 8718, "standard_charge_percentage": 75.0000, "estimated_amount": 8718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 8668.6, "standard_charge_percentage": 78.5000, "estimated_amount": 8668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 11042.8, "standard_charge_percentage": 95.0000, "estimated_amount": 11042, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 10461.6, "standard_charge_percentage": 90.0000, "estimated_amount": 10461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 9124.84, "standard_charge_percentage": 78.5000, "estimated_amount": 9124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 10171, "standard_charge_percentage": 87.5000, "estimated_amount": 10171, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 8851.09, "standard_charge_percentage": 78.5000, "estimated_amount": 8851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 8851.09, "standard_charge_percentage": 78.5000, "estimated_amount": 8851, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 9124.84, "standard_charge_percentage": 78.5000, "estimated_amount": 9124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 9033.59, "standard_charge_percentage": 78.5000, "estimated_amount": 9033, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 5812, "standard_charge_percentage": 50.0000, "estimated_amount": 5812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5812, "standard_charge_percentage": 50.0000, "estimated_amount": 5812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 4603.1, "standard_charge_percentage": 39.6000, "estimated_amount": 4603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9299.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9299, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 11624, "standard_charge_percentage": 100.0000, "estimated_amount": 11624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 8212.36, "standard_charge_percentage": 78.5000, "estimated_amount": 8212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 8851.09, "standard_charge_percentage": 78.5000, "estimated_amount": 8851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11981", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18166, "discounted_cash": 150,"minimum": 110.01,"maximum": 18166,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13547.3, "standard_charge_percentage": 78.5000, "estimated_amount": 13547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13547.3, "standard_charge_percentage": 78.5000, "estimated_amount": 13547, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 17802.7, "standard_charge_percentage": 98.0000, "estimated_amount": 17802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 162.12, "estimated_amount": 162, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7193.75, "standard_charge_percentage": 39.6000, "estimated_amount": 7193, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 179.49, "estimated_amount": 179, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14117.7, "standard_charge_percentage": 78.5000, "estimated_amount": 14117, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15441.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15441, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16349.4, "standard_charge_percentage": 90.0000, "estimated_amount": 16349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13119.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14260.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9083.02, "standard_charge_percentage": 50.0000, "estimated_amount": 9083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9083.02, "standard_charge_percentage": 50.0000, "estimated_amount": 9083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14260.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17257.7, "standard_charge_percentage": 95.0000, "estimated_amount": 17257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5449.81, "standard_charge_percentage": 30.0000, "estimated_amount": 5449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9083.02, "standard_charge_percentage": 50.0000, "estimated_amount": 9083, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16349.4, "standard_charge_percentage": 90.0000, "estimated_amount": 16349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 231.6, "estimated_amount": 231, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18166, "standard_charge_percentage": 100.0000, "estimated_amount": 18166, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14260.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 15895.3, "standard_charge_percentage": 87.5000, "estimated_amount": 15895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 114.64, "estimated_amount": 114, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 115.8, "estimated_amount": 115, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16349.4, "standard_charge_percentage": 90.0000, "estimated_amount": 16349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 12834.3, "standard_charge_percentage": 78.5000, "estimated_amount": 12834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 9991.32, "standard_charge_percentage": 55.0000, "estimated_amount": 9991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 110.01, "estimated_amount": 110, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15441.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 118.12, "estimated_amount": 118, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 116.96, "estimated_amount": 116, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 179.49, "estimated_amount": 179, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17257.7, "standard_charge_percentage": 95.0000, "estimated_amount": 17257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 13624.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13624, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr <2.5 Cm", "code_information": [ { "code": "12001", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1058.94, "discounted_cash": 232,"minimum": 169.58,"maximum": 1058.94,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 419.34, "standard_charge_percentage": 39.6000, "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 529.47, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 635.36, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 831.27, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 900.1, "standard_charge_percentage": 85.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 953.05, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 926.57, "standard_charge_percentage": 87.5000, "estimated_amount": 926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 831.27, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1005.99, "standard_charge_percentage": 95.0000, "estimated_amount": 1005, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 822.96, "standard_charge_percentage": 78.5000, "estimated_amount": 822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 529.47, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 582.42, "standard_charge_percentage": 55.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1058.94, "standard_charge_percentage": 100.0000, "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 794.21, "standard_charge_percentage": 75.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 953.05, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 831.27, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1037.76, "standard_charge_percentage": 98.0000, "estimated_amount": 1037, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1005.99, "standard_charge_percentage": 95.0000, "estimated_amount": 1005, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 953.05, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 423.58, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 900.1, "standard_charge_percentage": 85.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 764.77, "standard_charge_percentage": 78.5000, "estimated_amount": 764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 317.68, "standard_charge_percentage": 30.0000, "estimated_amount": 317, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 529.47, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 789.7, "standard_charge_percentage": 78.5000, "estimated_amount": 789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 789.7, "standard_charge_percentage": 78.5000, "estimated_amount": 789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 748.14, "standard_charge_percentage": 78.5000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr 2.6-7.5 Cm", "code_information": [ { "code": "12002", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1248.61, "discounted_cash": 232,"minimum": 169.58,"maximum": 1248.61,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 931.15, "standard_charge_percentage": 78.5000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 970.36, "standard_charge_percentage": 78.5000, "estimated_amount": 970, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 624.3, "standard_charge_percentage": 50.0000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1061.32, "standard_charge_percentage": 85.0000, "estimated_amount": 1061, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1123.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 624.3, "standard_charge_percentage": 50.0000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1186.18, "standard_charge_percentage": 95.0000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 686.74, "standard_charge_percentage": 55.0000, "estimated_amount": 686, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 980.16, "standard_charge_percentage": 78.5000, "estimated_amount": 980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1123.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1223.64, "standard_charge_percentage": 98.0000, "estimated_amount": 1223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 901.75, "standard_charge_percentage": 78.5000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1186.18, "standard_charge_percentage": 95.0000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 499.44, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 499, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 936.46, "standard_charge_percentage": 75.0000, "estimated_amount": 936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1123.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 749.17, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 624.3, "standard_charge_percentage": 50.0000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 980.16, "standard_charge_percentage": 78.5000, "estimated_amount": 980, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1061.32, "standard_charge_percentage": 85.0000, "estimated_amount": 1061, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 931.15, "standard_charge_percentage": 78.5000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 374.58, "standard_charge_percentage": 30.0000, "estimated_amount": 374, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 494.45, "standard_charge_percentage": 39.6000, "estimated_amount": 494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 882.14, "standard_charge_percentage": 78.5000, "estimated_amount": 882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 980.16, "standard_charge_percentage": 78.5000, "estimated_amount": 980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1092.53, "standard_charge_percentage": 87.5000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1248.61, "standard_charge_percentage": 100.0000, "estimated_amount": 1248, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr 7.6-12.5 Cm", "code_information": [ { "code": "12004", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1438.29, "discounted_cash": 232,"minimum": 169.58,"maximum": 20014,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1129.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1129.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 862.97, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 791.06, "standard_charge_percentage": 55.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 17011.9, "standard_charge_percentage": 85.0000, "estimated_amount": 17011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14139.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1072.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1072, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 19013.3, "standard_charge_percentage": 95.0000, "estimated_amount": 19013, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 719.14, "standard_charge_percentage": 50.0000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1294.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1294, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1294.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1294, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1409.52, "standard_charge_percentage": 98.0000, "estimated_amount": 1409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15553.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15553, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 20014, "standard_charge_percentage": 100.0000, "estimated_amount": 20014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 15010.5, "standard_charge_percentage": 75.0000, "estimated_amount": 15010, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 431.49, "standard_charge_percentage": 30.0000, "estimated_amount": 431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 719.14, "standard_charge_percentage": 50.0000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1016.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1117.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 569.56, "standard_charge_percentage": 39.6000, "estimated_amount": 569, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 719.14, "standard_charge_percentage": 50.0000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1258.5, "standard_charge_percentage": 87.5000, "estimated_amount": 1258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1222.55, "standard_charge_percentage": 85.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1366.38, "standard_charge_percentage": 95.0000, "estimated_amount": 1366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 17011.9, "standard_charge_percentage": 85.0000, "estimated_amount": 17011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1294.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1294, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14925.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14454.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7925.54, "standard_charge_percentage": 39.6000, "estimated_amount": 7925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1438.29, "standard_charge_percentage": 100.0000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 19013.3, "standard_charge_percentage": 95.0000, "estimated_amount": 19013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14925.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19613.7, "standard_charge_percentage": 98.0000, "estimated_amount": 19613, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1078.72, "standard_charge_percentage": 75.0000, "estimated_amount": 1078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1129.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 575.32, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6004.2, "standard_charge_percentage": 30.0000, "estimated_amount": 6004, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1072.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1072, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1366.38, "standard_charge_percentage": 95.0000, "estimated_amount": 1366, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1038.73, "standard_charge_percentage": 78.5000, "estimated_amount": 1038, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11007.7, "standard_charge_percentage": 55.0000, "estimated_amount": 11007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17512.3, "standard_charge_percentage": 87.5000, "estimated_amount": 17512, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1222.55, "standard_charge_percentage": 85.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr 12.6-20 Cm", "code_information": [ { "code": "12005", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 238.43,"maximum": 1679.85,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr 20.1-30 Cm", "code_information": [ { "code": "12006", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1765, "discounted_cash": 466,"minimum": 238.43,"maximum": 1765,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1544.38, "standard_charge_percentage": 87.5000, "estimated_amount": 1544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1588.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1588, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 882.5, "standard_charge_percentage": 50.0000, "estimated_amount": 882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1385.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1385, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 882.5, "standard_charge_percentage": 50.0000, "estimated_amount": 882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1343.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1343.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1316.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1343.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1059, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1059, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1588.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1588, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 882.5, "standard_charge_percentage": 50.0000, "estimated_amount": 882, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 698.94, "standard_charge_percentage": 39.6000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1323.75, "standard_charge_percentage": 75.0000, "estimated_amount": 1323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1385.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1385.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1500.25, "standard_charge_percentage": 85.0000, "estimated_amount": 1500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 970.75, "standard_charge_percentage": 55.0000, "estimated_amount": 970, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1343.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1274.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1274, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1588.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1588, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1765, "standard_charge_percentage": 100.0000, "estimated_amount": 1765, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1676.75, "standard_charge_percentage": 95.0000, "estimated_amount": 1676, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1316.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1676.75, "standard_charge_percentage": 95.0000, "estimated_amount": 1676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 529.5, "standard_charge_percentage": 30.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1246.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1246, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1343.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1500.25, "standard_charge_percentage": 85.0000, "estimated_amount": 1500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 706, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1412, "standard_charge_percentage": 80.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1729.7, "standard_charge_percentage": 98.0000, "estimated_amount": 1729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1371.67, "standard_charge_percentage": 78.5000, "estimated_amount": 1371, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr >30.1 Cm", "code_information": [ { "code": "12007", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1059, "discounted_cash": 232,"minimum": 169.58,"maximum": 1059,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 953.1, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 900.15, "standard_charge_percentage": 85.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 831.32, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 806.38, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 529.5, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1006.05, "standard_charge_percentage": 95.0000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 953.1, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 823, "standard_charge_percentage": 78.5000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 635.4, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1037.82, "standard_charge_percentage": 98.0000, "estimated_amount": 1037, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 317.7, "standard_charge_percentage": 30.0000, "estimated_amount": 317, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 419.36, "standard_charge_percentage": 39.6000, "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 789.75, "standard_charge_percentage": 78.5000, "estimated_amount": 789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 806.38, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 529.5, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 764.81, "standard_charge_percentage": 78.5000, "estimated_amount": 764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 529.5, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1006.05, "standard_charge_percentage": 95.0000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 794.25, "standard_charge_percentage": 75.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 806.38, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 806.38, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 806.38, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 748.18, "standard_charge_percentage": 78.5000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 831.32, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 831.32, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1059, "standard_charge_percentage": 100.0000, "estimated_amount": 1059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 900.15, "standard_charge_percentage": 85.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 423.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 953.1, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 582.45, "standard_charge_percentage": 55.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 926.63, "standard_charge_percentage": 87.5000, "estimated_amount": 926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 847.2, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 789.75, "standard_charge_percentage": 78.5000, "estimated_amount": 789, "methodology": "percent of total billed charges" }]}]} , { "description": "Rpr F/E/E/N/L/M 2.5 Cm/<", "code_information": [ { "code": "12011", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 848.06, "discounted_cash": 232,"minimum": 169.58,"maximum": 848.06,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 848.06, "standard_charge_percentage": 100.0000, "estimated_amount": 848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 636.04, "standard_charge_percentage": 75.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 763.25, "standard_charge_percentage": 90.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 805.66, "standard_charge_percentage": 95.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 254.42, "standard_charge_percentage": 30.0000, "estimated_amount": 254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 339.22, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 763.25, "standard_charge_percentage": 90.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 659.07, "standard_charge_percentage": 78.5000, "estimated_amount": 659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 335.83, "standard_charge_percentage": 39.6000, "estimated_amount": 335, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 665.73, "standard_charge_percentage": 78.5000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 632.44, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 424.03, "standard_charge_percentage": 50.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 720.85, "standard_charge_percentage": 85.0000, "estimated_amount": 720, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 665.73, "standard_charge_percentage": 78.5000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 466.43, "standard_charge_percentage": 55.0000, "estimated_amount": 466, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 720.85, "standard_charge_percentage": 85.0000, "estimated_amount": 720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 424.03, "standard_charge_percentage": 50.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 742.05, "standard_charge_percentage": 87.5000, "estimated_amount": 742, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 508.84, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 508, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 599.15, "standard_charge_percentage": 78.5000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 632.44, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 80.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 665.73, "standard_charge_percentage": 78.5000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 424.03, "standard_charge_percentage": 50.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 645.76, "standard_charge_percentage": 78.5000, "estimated_amount": 645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 612.47, "standard_charge_percentage": 78.5000, "estimated_amount": 612, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 805.66, "standard_charge_percentage": 95.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 831.1, "standard_charge_percentage": 98.0000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 763.25, "standard_charge_percentage": 90.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Smp Face 2.6-5.0 Cm", "code_information": [ { "code": "12013", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1058.94, "discounted_cash": 232,"minimum": 169.58,"maximum": 1058.94,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 926.57, "standard_charge_percentage": 87.5000, "estimated_amount": 926, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 764.77, "standard_charge_percentage": 78.5000, "estimated_amount": 764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 423.58, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 953.05, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 953.05, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 900.1, "standard_charge_percentage": 85.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 789.7, "standard_charge_percentage": 78.5000, "estimated_amount": 789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 419.34, "standard_charge_percentage": 39.6000, "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 635.36, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 317.68, "standard_charge_percentage": 30.0000, "estimated_amount": 317, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 831.27, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 529.47, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 789.7, "standard_charge_percentage": 78.5000, "estimated_amount": 789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 900.1, "standard_charge_percentage": 85.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 748.14, "standard_charge_percentage": 78.5000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1005.99, "standard_charge_percentage": 95.0000, "estimated_amount": 1005, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1037.76, "standard_charge_percentage": 98.0000, "estimated_amount": 1037, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 529.47, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 582.42, "standard_charge_percentage": 55.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 806.33, "standard_charge_percentage": 78.5000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 794.21, "standard_charge_percentage": 75.0000, "estimated_amount": 794, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 831.27, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1005.99, "standard_charge_percentage": 95.0000, "estimated_amount": 1005, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1058.94, "standard_charge_percentage": 100.0000, "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 953.05, "standard_charge_percentage": 90.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 822.96, "standard_charge_percentage": 78.5000, "estimated_amount": 822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 831.27, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 529.47, "standard_charge_percentage": 50.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 847.15, "standard_charge_percentage": 80.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Smp Face 5.1-7.5 Cm", "code_information": [ { "code": "12014", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1248.61, "discounted_cash": 232,"minimum": 169.58,"maximum": 1248.61,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1186.18, "standard_charge_percentage": 95.0000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 980.16, "standard_charge_percentage": 78.5000, "estimated_amount": 980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1061.32, "standard_charge_percentage": 85.0000, "estimated_amount": 1061, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1223.64, "standard_charge_percentage": 98.0000, "estimated_amount": 1223, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 499.44, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 499, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1248.61, "standard_charge_percentage": 100.0000, "estimated_amount": 1248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1123.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1123.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 374.58, "standard_charge_percentage": 30.0000, "estimated_amount": 374, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 901.75, "standard_charge_percentage": 78.5000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 970.36, "standard_charge_percentage": 78.5000, "estimated_amount": 970, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 936.46, "standard_charge_percentage": 75.0000, "estimated_amount": 936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1092.53, "standard_charge_percentage": 87.5000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 980.16, "standard_charge_percentage": 78.5000, "estimated_amount": 980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 882.14, "standard_charge_percentage": 78.5000, "estimated_amount": 882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 624.3, "standard_charge_percentage": 50.0000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1123.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 950.75, "standard_charge_percentage": 78.5000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 749.17, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 980.16, "standard_charge_percentage": 78.5000, "estimated_amount": 980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1186.18, "standard_charge_percentage": 95.0000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 686.74, "standard_charge_percentage": 55.0000, "estimated_amount": 686, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 624.3, "standard_charge_percentage": 50.0000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 998.89, "standard_charge_percentage": 80.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 494.45, "standard_charge_percentage": 39.6000, "estimated_amount": 494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1061.32, "standard_charge_percentage": 85.0000, "estimated_amount": 1061, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 931.15, "standard_charge_percentage": 78.5000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 624.3, "standard_charge_percentage": 50.0000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 931.15, "standard_charge_percentage": 78.5000, "estimated_amount": 931, "methodology": "percent of total billed charges" }]}]} , { "description": "Rpr feenlm 7.6-12.5 cm", "code_information": [ { "code": "12015", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1438.29, "discounted_cash": 232,"minimum": 169.58,"maximum": 1438.29,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1294.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1294, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1129.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 719.14, "standard_charge_percentage": 50.0000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 431.49, "standard_charge_percentage": 30.0000, "estimated_amount": 431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1366.38, "standard_charge_percentage": 95.0000, "estimated_amount": 1366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1016.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 791.06, "standard_charge_percentage": 55.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1038.73, "standard_charge_percentage": 78.5000, "estimated_amount": 1038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 569.56, "standard_charge_percentage": 39.6000, "estimated_amount": 569, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1072.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1072, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1294.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1294, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1129.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1117.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1366.38, "standard_charge_percentage": 95.0000, "estimated_amount": 1366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1129.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 719.14, "standard_charge_percentage": 50.0000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1294.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1294, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 719.14, "standard_charge_percentage": 50.0000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1438.29, "standard_charge_percentage": 100.0000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1095.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1150.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1222.55, "standard_charge_percentage": 85.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1222.55, "standard_charge_percentage": 85.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1258.5, "standard_charge_percentage": 87.5000, "estimated_amount": 1258, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1409.52, "standard_charge_percentage": 98.0000, "estimated_amount": 1409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1072.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1072, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 862.97, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 575.32, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1078.72, "standard_charge_percentage": 75.0000, "estimated_amount": 1078, "methodology": "percent of total billed charges" }]}]} , { "description": "Rpr feeenlm 12.6-20.0 cm", "code_information": [ { "code": "12016", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 819.6, "discounted_cash": 466,"minimum": 238.43,"maximum": 819.6,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 737.64, "standard_charge_percentage": 90.0000, "estimated_amount": 737, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 579.05, "standard_charge_percentage": 78.5000, "estimated_amount": 579, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 737.64, "standard_charge_percentage": 90.0000, "estimated_amount": 737, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 643.39, "standard_charge_percentage": 78.5000, "estimated_amount": 643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 409.8, "standard_charge_percentage": 50.0000, "estimated_amount": 409, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 614.7, "standard_charge_percentage": 75.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 624.08, "standard_charge_percentage": 78.5000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 643.39, "standard_charge_percentage": 78.5000, "estimated_amount": 643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 778.62, "standard_charge_percentage": 95.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 803.21, "standard_charge_percentage": 98.0000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 245.88, "standard_charge_percentage": 30.0000, "estimated_amount": 245, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 409.8, "standard_charge_percentage": 50.0000, "estimated_amount": 409, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 324.56, "standard_charge_percentage": 39.6000, "estimated_amount": 324, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 636.95, "standard_charge_percentage": 78.5000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 624.08, "standard_charge_percentage": 78.5000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 409.8, "standard_charge_percentage": 50.0000, "estimated_amount": 409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 611.22, "standard_charge_percentage": 78.5000, "estimated_amount": 611, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 696.66, "standard_charge_percentage": 85.0000, "estimated_amount": 696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 737.64, "standard_charge_percentage": 90.0000, "estimated_amount": 737, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 450.78, "standard_charge_percentage": 55.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 327.84, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 327, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 778.62, "standard_charge_percentage": 95.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 624.08, "standard_charge_percentage": 78.5000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 643.39, "standard_charge_percentage": 78.5000, "estimated_amount": 643, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 696.66, "standard_charge_percentage": 85.0000, "estimated_amount": 696, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 591.92, "standard_charge_percentage": 78.5000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 655.68, "standard_charge_percentage": 80.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 624.08, "standard_charge_percentage": 78.5000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 611.22, "standard_charge_percentage": 78.5000, "estimated_amount": 611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 717.15, "standard_charge_percentage": 87.5000, "estimated_amount": 717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 624.08, "standard_charge_percentage": 78.5000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 819.6, "standard_charge_percentage": 100.0000, "estimated_amount": 819, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 491.76, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Face 20.1-30 Cm", "code_information": [ { "code": "12017", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 973, "discounted_cash": 466,"minimum": 238.43,"maximum": 973,"payers_information":[{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 291.9, "standard_charge_percentage": 30.0000, "estimated_amount": 291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 725.61, "standard_charge_percentage": 78.5000, "estimated_amount": 725, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 875.7, "standard_charge_percentage": 90.0000, "estimated_amount": 875, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 702.7, "standard_charge_percentage": 78.5000, "estimated_amount": 702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 953.54, "standard_charge_percentage": 98.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 385.31, "standard_charge_percentage": 39.6000, "estimated_amount": 385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 740.89, "standard_charge_percentage": 78.5000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 827.05, "standard_charge_percentage": 85.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 535.15, "standard_charge_percentage": 55.0000, "estimated_amount": 535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 875.7, "standard_charge_percentage": 90.0000, "estimated_amount": 875, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 740.89, "standard_charge_percentage": 78.5000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 583.8, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 583, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 827.05, "standard_charge_percentage": 85.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 924.35, "standard_charge_percentage": 95.0000, "estimated_amount": 924, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 973, "standard_charge_percentage": 100.0000, "estimated_amount": 973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 687.42, "standard_charge_percentage": 78.5000, "estimated_amount": 687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 740.89, "standard_charge_percentage": 78.5000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 763.8, "standard_charge_percentage": 78.5000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 740.89, "standard_charge_percentage": 78.5000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 486.5, "standard_charge_percentage": 50.0000, "estimated_amount": 486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 763.8, "standard_charge_percentage": 78.5000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 725.61, "standard_charge_percentage": 78.5000, "estimated_amount": 725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 486.5, "standard_charge_percentage": 50.0000, "estimated_amount": 486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 763.8, "standard_charge_percentage": 78.5000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 756.17, "standard_charge_percentage": 78.5000, "estimated_amount": 756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 740.89, "standard_charge_percentage": 78.5000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 875.7, "standard_charge_percentage": 90.0000, "estimated_amount": 875, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 729.75, "standard_charge_percentage": 75.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 389.2, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 389, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 924.35, "standard_charge_percentage": 95.0000, "estimated_amount": 924, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 486.5, "standard_charge_percentage": 50.0000, "estimated_amount": 486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 851.38, "standard_charge_percentage": 87.5000, "estimated_amount": 851, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Smp Face >30.1 Cm", "code_information": [ { "code": "12018", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1132.85, "discounted_cash": 232,"minimum": 169.58,"maximum": 1132.85,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 844.82, "standard_charge_percentage": 78.5000, "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1019.56, "standard_charge_percentage": 90.0000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1132.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 862.61, "standard_charge_percentage": 78.5000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 880.39, "standard_charge_percentage": 78.5000, "estimated_amount": 880, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 862.61, "standard_charge_percentage": 78.5000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1110.19, "standard_charge_percentage": 98.0000, "estimated_amount": 1110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 862.61, "standard_charge_percentage": 78.5000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 623.07, "standard_charge_percentage": 55.0000, "estimated_amount": 623, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 566.42, "standard_charge_percentage": 50.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1076.21, "standard_charge_percentage": 95.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1076.21, "standard_charge_percentage": 95.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 962.92, "standard_charge_percentage": 85.0000, "estimated_amount": 962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 679.71, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 889.29, "standard_charge_percentage": 78.5000, "estimated_amount": 889, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 448.61, "standard_charge_percentage": 39.6000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 566.42, "standard_charge_percentage": 50.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 862.61, "standard_charge_percentage": 78.5000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 844.82, "standard_charge_percentage": 78.5000, "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 962.92, "standard_charge_percentage": 85.0000, "estimated_amount": 962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1019.56, "standard_charge_percentage": 90.0000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 889.29, "standard_charge_percentage": 78.5000, "estimated_amount": 889, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 849.64, "standard_charge_percentage": 75.0000, "estimated_amount": 849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 862.61, "standard_charge_percentage": 78.5000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 991.24, "standard_charge_percentage": 87.5000, "estimated_amount": 991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1019.56, "standard_charge_percentage": 90.0000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 339.86, "standard_charge_percentage": 30.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 818.14, "standard_charge_percentage": 78.5000, "estimated_amount": 818, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 906.28, "standard_charge_percentage": 80.0000, "estimated_amount": 906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 566.42, "standard_charge_percentage": 50.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 453.14, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 889.29, "standard_charge_percentage": 78.5000, "estimated_amount": 889, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 800.36, "standard_charge_percentage": 78.5000, "estimated_amount": 800, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Treat Wnd Dehiscence, Simple Closure", "code_information": [ { "code": "12020", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1164.23, "discounted_cash": 714,"minimum": 243.24,"maximum": 1164.23,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1047.81, "standard_charge_percentage": 90.0000, "estimated_amount": 1047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 868.22, "standard_charge_percentage": 78.5000, "estimated_amount": 868, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1140.95, "standard_charge_percentage": 98.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 461.04, "standard_charge_percentage": 39.6000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1106.02, "standard_charge_percentage": 95.0000, "estimated_amount": 1106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 886.5, "standard_charge_percentage": 78.5000, "estimated_amount": 886, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 465.69, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 465, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 989.6, "standard_charge_percentage": 85.0000, "estimated_amount": 989, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 582.12, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 873.17, "standard_charge_percentage": 75.0000, "estimated_amount": 873, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 349.27, "standard_charge_percentage": 30.0000, "estimated_amount": 349, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 840.81, "standard_charge_percentage": 78.5000, "estimated_amount": 840, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 913.92, "standard_charge_percentage": 78.5000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 989.6, "standard_charge_percentage": 85.0000, "estimated_amount": 989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 886.5, "standard_charge_percentage": 78.5000, "estimated_amount": 886, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 582.12, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1047.81, "standard_charge_percentage": 90.0000, "estimated_amount": 1047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 640.33, "standard_charge_percentage": 55.0000, "estimated_amount": 640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 913.92, "standard_charge_percentage": 78.5000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 886.5, "standard_charge_percentage": 78.5000, "estimated_amount": 886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1018.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 868.22, "standard_charge_percentage": 78.5000, "estimated_amount": 868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1164.23, "standard_charge_percentage": 100.0000, "estimated_amount": 1164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 886.5, "standard_charge_percentage": 78.5000, "estimated_amount": 886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 913.92, "standard_charge_percentage": 78.5000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 582.12, "standard_charge_percentage": 50.0000, "estimated_amount": 582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 822.53, "standard_charge_percentage": 78.5000, "estimated_amount": 822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1106.02, "standard_charge_percentage": 95.0000, "estimated_amount": 1106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 904.78, "standard_charge_percentage": 78.5000, "estimated_amount": 904, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1047.81, "standard_charge_percentage": 90.0000, "estimated_amount": 1047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 698.54, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 931.38, "standard_charge_percentage": 80.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 886.5, "standard_charge_percentage": 78.5000, "estimated_amount": 886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" }]}]} , { "description": "Intmd rpr satext 2.5 cm<", "code_information": [ { "code": "12031", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1048.06, "discounted_cash": 466,"minimum": 314.42,"maximum": 1048.06,"payers_information":[{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 822.73, "standard_charge_percentage": 78.5000, "estimated_amount": 822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 798.05, "standard_charge_percentage": 78.5000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 995.66, "standard_charge_percentage": 95.0000, "estimated_amount": 995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 756.91, "standard_charge_percentage": 78.5000, "estimated_amount": 756, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 798.05, "standard_charge_percentage": 78.5000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 419.22, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 786.04, "standard_charge_percentage": 75.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 740.45, "standard_charge_percentage": 78.5000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1048.06, "standard_charge_percentage": 100.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 781.59, "standard_charge_percentage": 78.5000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 943.25, "standard_charge_percentage": 90.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 524.03, "standard_charge_percentage": 50.0000, "estimated_amount": 524, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 576.43, "standard_charge_percentage": 55.0000, "estimated_amount": 576, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 943.25, "standard_charge_percentage": 90.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1027.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 890.85, "standard_charge_percentage": 85.0000, "estimated_amount": 890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 415.03, "standard_charge_percentage": 39.6000, "estimated_amount": 415, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 917.05, "standard_charge_percentage": 87.5000, "estimated_amount": 917, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 314.42, "standard_charge_percentage": 30.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 822.73, "standard_charge_percentage": 78.5000, "estimated_amount": 822, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 890.85, "standard_charge_percentage": 85.0000, "estimated_amount": 890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 628.84, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 524.03, "standard_charge_percentage": 50.0000, "estimated_amount": 524, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 798.05, "standard_charge_percentage": 78.5000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 943.25, "standard_charge_percentage": 90.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 524.03, "standard_charge_percentage": 50.0000, "estimated_amount": 524, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 798.05, "standard_charge_percentage": 78.5000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 781.59, "standard_charge_percentage": 78.5000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 798.05, "standard_charge_percentage": 78.5000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 838.45, "standard_charge_percentage": 80.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 995.66, "standard_charge_percentage": 95.0000, "estimated_amount": 995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 822.73, "standard_charge_percentage": 78.5000, "estimated_amount": 822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 814.5, "standard_charge_percentage": 78.5000, "estimated_amount": 814, "methodology": "percent of total billed charges" }]}]} , { "description": "Intmd rpr satext 2.6-7.5", "code_information": [ { "code": "12032", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 243.24,"maximum": 1679.85,"payers_information":[{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" }]}]} , { "description": "Intmd rpr strext 7.6-12.5", "code_information": [ { "code": "12034", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 243.24,"maximum": 1679.85,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" }]}]} , { "description": "Intmd rpr satext 12.6-20", "code_information": [ { "code": "12035", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 243.24,"maximum": 1679.85,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Body/Scalp/Extr 20.1-30 Cm", "code_information": [ { "code": "12036", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2645.85, "discounted_cash": 714,"minimum": 325.58,"maximum": 2645.85,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1587.51, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2056.22, "standard_charge_percentage": 78.5000, "estimated_amount": 2056, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2592.93, "standard_charge_percentage": 98.0000, "estimated_amount": 2592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2315.12, "standard_charge_percentage": 87.5000, "estimated_amount": 2315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2248.97, "standard_charge_percentage": 85.0000, "estimated_amount": 2248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2248.97, "standard_charge_percentage": 85.0000, "estimated_amount": 2248, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1910.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1910, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1047.76, "standard_charge_percentage": 39.6000, "estimated_amount": 1047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1973.14, "standard_charge_percentage": 78.5000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2381.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2076.99, "standard_charge_percentage": 78.5000, "estimated_amount": 2076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1984.39, "standard_charge_percentage": 75.0000, "estimated_amount": 1984, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2645.85, "standard_charge_percentage": 100.0000, "estimated_amount": 2645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1058.34, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1869.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1973.14, "standard_charge_percentage": 78.5000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1455.22, "standard_charge_percentage": 55.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 793.75, "standard_charge_percentage": 30.0000, "estimated_amount": 793, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1322.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2513.56, "standard_charge_percentage": 95.0000, "estimated_amount": 2513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2513.56, "standard_charge_percentage": 95.0000, "estimated_amount": 2513, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2014.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2116.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Body/Scalp/Extr >30.1 Cm", "code_information": [ { "code": "12037", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1899.22, "discounted_cash": 2136,"minimum": 325.58,"maximum": 1899.22,"payers_information":[{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1446.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1614.34, "standard_charge_percentage": 85.0000, "estimated_amount": 1614, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1804.26, "standard_charge_percentage": 95.0000, "estimated_amount": 1804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 949.61, "standard_charge_percentage": 50.0000, "estimated_amount": 949, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 752.09, "standard_charge_percentage": 39.6000, "estimated_amount": 752, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1475.98, "standard_charge_percentage": 78.5000, "estimated_amount": 1475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1899.22, "estimated_amount": 1899, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1899.22, "estimated_amount": 1899, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1446.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1371.62, "standard_charge_percentage": 78.5000, "estimated_amount": 1371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1416.34, "standard_charge_percentage": 78.5000, "estimated_amount": 1416, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1424.41, "standard_charge_percentage": 75.0000, "estimated_amount": 1424, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1861.24, "standard_charge_percentage": 98.0000, "estimated_amount": 1861, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1490.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1416.34, "standard_charge_percentage": 78.5000, "estimated_amount": 1416, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1490.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1490, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1709.3, "standard_charge_percentage": 90.0000, "estimated_amount": 1709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 949.61, "standard_charge_percentage": 50.0000, "estimated_amount": 949, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1139.53, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1899.22, "estimated_amount": 1899, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 569.77, "standard_charge_percentage": 30.0000, "estimated_amount": 569, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1446.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1899.22, "estimated_amount": 1899, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1044.57, "standard_charge_percentage": 55.0000, "estimated_amount": 1044, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1341.8, "standard_charge_percentage": 78.5000, "estimated_amount": 1341, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1804.26, "standard_charge_percentage": 95.0000, "estimated_amount": 1804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1446.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1446.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1709.3, "standard_charge_percentage": 90.0000, "estimated_amount": 1709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1661.82, "standard_charge_percentage": 87.5000, "estimated_amount": 1661, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1899.22, "standard_charge_percentage": 100.0000, "estimated_amount": 1899, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 759.69, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1709.3, "standard_charge_percentage": 90.0000, "estimated_amount": 1709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1490.89, "standard_charge_percentage": 78.5000, "estimated_amount": 1490, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 949.61, "standard_charge_percentage": 50.0000, "estimated_amount": 949, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1614.34, "standard_charge_percentage": 85.0000, "estimated_amount": 1614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1519.38, "standard_charge_percentage": 80.0000, "estimated_amount": 1519, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent <2.5 Cm", "code_information": [ { "code": "12041", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 243.24,"maximum": 1679.85,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" }]}]} , { "description": "Intmd rpr n-hfgenit2.6-7.5", "code_information": [ { "code": "12042", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 243.24,"maximum": 1679.85,"payers_information":[{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 7.6-12.5 Cm", "code_information": [ { "code": "12044", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1718.16, "discounted_cash": 714,"minimum": 243.24,"maximum": 1718.16,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1030.9, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1348.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1632.25, "standard_charge_percentage": 95.0000, "estimated_amount": 1632, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1683.8, "standard_charge_percentage": 98.0000, "estimated_amount": 1683, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 687.26, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1546.34, "standard_charge_percentage": 90.0000, "estimated_amount": 1546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1308.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1503.39, "standard_charge_percentage": 87.5000, "estimated_amount": 1503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1288.62, "standard_charge_percentage": 75.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 680.39, "standard_charge_percentage": 39.6000, "estimated_amount": 680, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1308.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1213.88, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1308.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 859.08, "standard_charge_percentage": 50.0000, "estimated_amount": 859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1348.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1546.34, "standard_charge_percentage": 90.0000, "estimated_amount": 1546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1460.44, "standard_charge_percentage": 85.0000, "estimated_amount": 1460, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 859.08, "standard_charge_percentage": 50.0000, "estimated_amount": 859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1308.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1240.86, "standard_charge_percentage": 78.5000, "estimated_amount": 1240, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1460.44, "standard_charge_percentage": 85.0000, "estimated_amount": 1460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1718.16, "standard_charge_percentage": 100.0000, "estimated_amount": 1718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 515.45, "standard_charge_percentage": 30.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 944.99, "standard_charge_percentage": 55.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 859.08, "standard_charge_percentage": 50.0000, "estimated_amount": 859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1281.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1335.27, "standard_charge_percentage": 78.5000, "estimated_amount": 1335, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1546.34, "standard_charge_percentage": 90.0000, "estimated_amount": 1546, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1308.29, "standard_charge_percentage": 78.5000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1281.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1281, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1374.53, "standard_charge_percentage": 80.0000, "estimated_amount": 1374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1348.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1632.25, "standard_charge_percentage": 95.0000, "estimated_amount": 1632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 12.5-20 Cm", "code_information": [ { "code": "12045", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23, "discounted_cash": 714,"minimum": 325.58,"maximum": 2036.23,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 20.1-30 Cm", "code_information": [ { "code": "12046", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2336.23, "discounted_cash": 714,"minimum": 325.58,"maximum": 2336.23,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1778.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2102.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2219.42, "standard_charge_percentage": 95.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1778.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1284.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 700.87, "standard_charge_percentage": 30.0000, "estimated_amount": 700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1752.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1752, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 925.15, "standard_charge_percentage": 39.6000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1985.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1985, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1687.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2102.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2102.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1168.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1778.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1778.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2219.42, "standard_charge_percentage": 95.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1833.94, "standard_charge_percentage": 78.5000, "estimated_amount": 1833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1650.55, "standard_charge_percentage": 78.5000, "estimated_amount": 1650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1778.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1401.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1401, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2044.2, "standard_charge_percentage": 87.5000, "estimated_amount": 2044, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1833.94, "standard_charge_percentage": 78.5000, "estimated_amount": 1833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1815.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1833.94, "standard_charge_percentage": 78.5000, "estimated_amount": 1833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2336.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2336, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1168.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1168, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1168.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1168, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1868.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1742.24, "standard_charge_percentage": 78.5000, "estimated_amount": 1742, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 934.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 934, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2289.51, "standard_charge_percentage": 98.0000, "estimated_amount": 2289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1742.24, "standard_charge_percentage": 78.5000, "estimated_amount": 1742, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1985.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1985, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent >30.1 Cm", "code_information": [ { "code": "12047", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2436.23, "discounted_cash": 2136,"minimum": 325.58,"maximum": 2436.23,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1816.82, "standard_charge_percentage": 78.5000, "estimated_amount": 1816, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1827.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2314.42, "standard_charge_percentage": 95.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1721.2, "standard_charge_percentage": 78.5000, "estimated_amount": 1721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1759.45, "standard_charge_percentage": 78.5000, "estimated_amount": 1759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1218.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1218, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2436.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2070.8, "standard_charge_percentage": 85.0000, "estimated_amount": 2070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1893.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2314.42, "standard_charge_percentage": 95.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1912.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 974.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 730.87, "standard_charge_percentage": 30.0000, "estimated_amount": 730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1912.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1461.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1461, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1218.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1912.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1912, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 964.75, "standard_charge_percentage": 39.6000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2387.51, "standard_charge_percentage": 98.0000, "estimated_amount": 2387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1816.82, "standard_charge_percentage": 78.5000, "estimated_amount": 1816, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2192.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2192, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2131.7, "standard_charge_percentage": 87.5000, "estimated_amount": 2131, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2070.8, "standard_charge_percentage": 85.0000, "estimated_amount": 2070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2192.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1218.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2436.23, "estimated_amount": 2436, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2436.23, "estimated_amount": 2436, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2192.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1339.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2436.23, "estimated_amount": 2436, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Face <2.5 Cm", "code_information": [ { "code": "12051", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 340.99,"maximum": 1679.85,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Face 2.6-5.0 Cm", "code_information": [ { "code": "12052", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1679.85, "discounted_cash": 466,"minimum": 243.24,"maximum": 1679.85,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1679.85, "standard_charge_percentage": 100.0000, "estimated_amount": 1679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1595.86, "standard_charge_percentage": 95.0000, "estimated_amount": 1595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1469.87, "standard_charge_percentage": 87.5000, "estimated_amount": 1469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 503.95, "standard_charge_percentage": 30.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1007.91, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 671.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 923.92, "standard_charge_percentage": 55.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 839.92, "standard_charge_percentage": 50.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1511.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1305.5, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1343.88, "standard_charge_percentage": 80.0000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1279.12, "standard_charge_percentage": 78.5000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1259.89, "standard_charge_percentage": 75.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1252.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 665.22, "standard_charge_percentage": 39.6000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1427.87, "standard_charge_percentage": 85.0000, "estimated_amount": 1427, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1186.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1186, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1213.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1213, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1646.25, "standard_charge_percentage": 98.0000, "estimated_amount": 1646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1318.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1318, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Face 5.1-7.5 Cm", "code_information": [ { "code": "12053", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 820.97, "discounted_cash": 466,"minimum": 243.24,"maximum": 820.97,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 328.39, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 625.13, "standard_charge_percentage": 78.5000, "estimated_amount": 625, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 325.1, "standard_charge_percentage": 39.6000, "estimated_amount": 325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 625.13, "standard_charge_percentage": 78.5000, "estimated_amount": 625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 644.46, "standard_charge_percentage": 78.5000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 625.13, "standard_charge_percentage": 78.5000, "estimated_amount": 625, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 697.82, "standard_charge_percentage": 85.0000, "estimated_amount": 697, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 697.82, "standard_charge_percentage": 85.0000, "estimated_amount": 697, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 804.55, "standard_charge_percentage": 98.0000, "estimated_amount": 804, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 625.13, "standard_charge_percentage": 78.5000, "estimated_amount": 625, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 492.58, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 492, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 410.49, "standard_charge_percentage": 50.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 246.29, "standard_charge_percentage": 30.0000, "estimated_amount": 246, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 644.46, "standard_charge_percentage": 78.5000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 612.24, "standard_charge_percentage": 78.5000, "estimated_amount": 612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 615.73, "standard_charge_percentage": 75.0000, "estimated_amount": 615, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 738.87, "standard_charge_percentage": 90.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 625.13, "standard_charge_percentage": 78.5000, "estimated_amount": 625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 580.02, "standard_charge_percentage": 78.5000, "estimated_amount": 580, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 410.49, "standard_charge_percentage": 50.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 779.92, "standard_charge_percentage": 95.0000, "estimated_amount": 779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 644.46, "standard_charge_percentage": 78.5000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 410.49, "standard_charge_percentage": 50.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 638.02, "standard_charge_percentage": 78.5000, "estimated_amount": 638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 612.24, "standard_charge_percentage": 78.5000, "estimated_amount": 612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 738.87, "standard_charge_percentage": 90.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 718.35, "standard_charge_percentage": 87.5000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 738.87, "standard_charge_percentage": 90.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 656.78, "standard_charge_percentage": 80.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 779.92, "standard_charge_percentage": 95.0000, "estimated_amount": 779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 820.97, "standard_charge_percentage": 100.0000, "estimated_amount": 820, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 451.53, "standard_charge_percentage": 55.0000, "estimated_amount": 451, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 592.9, "standard_charge_percentage": 78.5000, "estimated_amount": 592, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Intrmd Face 7.6-12.5 Cm", "code_information": [ { "code": "12054", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2087.14, "discounted_cash": 466,"minimum": 243.24,"maximum": 2087.14,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1826.25, "standard_charge_percentage": 87.5000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 626.14, "standard_charge_percentage": 30.0000, "estimated_amount": 626, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1556.48, "standard_charge_percentage": 78.5000, "estimated_amount": 1556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1565.36, "standard_charge_percentage": 75.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1878.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1878, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1507.33, "standard_charge_percentage": 78.5000, "estimated_amount": 1507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1878.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1556.48, "standard_charge_percentage": 78.5000, "estimated_amount": 1556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 826.51, "standard_charge_percentage": 39.6000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1043.57, "standard_charge_percentage": 50.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 834.86, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 834, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1982.78, "standard_charge_percentage": 95.0000, "estimated_amount": 1982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1638.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1252.28, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2087.14, "standard_charge_percentage": 100.0000, "estimated_amount": 2087, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1878.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1638.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1638, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2045.4, "standard_charge_percentage": 98.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1774.07, "standard_charge_percentage": 85.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1474.56, "standard_charge_percentage": 78.5000, "estimated_amount": 1474, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1638.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1638, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1774.07, "standard_charge_percentage": 85.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1043.57, "standard_charge_percentage": 50.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1982.78, "standard_charge_percentage": 95.0000, "estimated_amount": 1982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1147.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1622.02, "standard_charge_percentage": 78.5000, "estimated_amount": 1622, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1043.57, "standard_charge_percentage": 50.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" }]}]} , { "description": "Intmd rpr facemm 12.6-20 cm", "code_information": [ { "code": "12055", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23, "discounted_cash": 466,"minimum": 243.24,"maximum": 2036.23,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" }]}]} , { "description": "Intmd rpr facemm 20.1-30.0", "code_information": [ { "code": "12056", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23, "discounted_cash": 466,"minimum": 325.58,"maximum": 2036.23,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Face >30.1 Cm", "code_information": [ { "code": "12057", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1367.83, "discounted_cash": 466,"minimum": 325.58,"maximum": 1367.83,"payers_information":[{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 752.31, "standard_charge_percentage": 55.0000, "estimated_amount": 752, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1041.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1041.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1073.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1073, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1020.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1020.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1162.66, "standard_charge_percentage": 85.0000, "estimated_amount": 1162, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1299.44, "standard_charge_percentage": 95.0000, "estimated_amount": 1299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1299.44, "standard_charge_percentage": 95.0000, "estimated_amount": 1299, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 987.85, "standard_charge_percentage": 78.5000, "estimated_amount": 987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 410.35, "standard_charge_percentage": 30.0000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1073.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1073, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1367.83, "standard_charge_percentage": 100.0000, "estimated_amount": 1367, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 683.91, "standard_charge_percentage": 50.0000, "estimated_amount": 683, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1162.66, "standard_charge_percentage": 85.0000, "estimated_amount": 1162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 541.66, "standard_charge_percentage": 39.6000, "estimated_amount": 541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1340.47, "standard_charge_percentage": 98.0000, "estimated_amount": 1340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1041.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 683.91, "standard_charge_percentage": 50.0000, "estimated_amount": 683, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 966.37, "standard_charge_percentage": 78.5000, "estimated_amount": 966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1041.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 547.13, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1231.05, "standard_charge_percentage": 90.0000, "estimated_amount": 1231, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1196.85, "standard_charge_percentage": 87.5000, "estimated_amount": 1196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1231.05, "standard_charge_percentage": 90.0000, "estimated_amount": 1231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1025.87, "standard_charge_percentage": 75.0000, "estimated_amount": 1025, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1073.75, "standard_charge_percentage": 78.5000, "estimated_amount": 1073, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 820.7, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 820, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1041.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1063.01, "standard_charge_percentage": 78.5000, "estimated_amount": 1063, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 683.91, "standard_charge_percentage": 50.0000, "estimated_amount": 683, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1094.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1231.05, "standard_charge_percentage": 90.0000, "estimated_amount": 1231, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Trunk 1.1-2.5 Cm", "code_information": [ { "code": "13100", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7056.05, "discounted_cash": 714,"minimum": 243.24,"maximum": 7056.05,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5262.05, "standard_charge_percentage": 78.5000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2794.2, "standard_charge_percentage": 39.6000, "estimated_amount": 2794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5997.64, "standard_charge_percentage": 85.0000, "estimated_amount": 5997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2116.82, "standard_charge_percentage": 30.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6703.25, "standard_charge_percentage": 95.0000, "estimated_amount": 6703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5539, "standard_charge_percentage": 78.5000, "estimated_amount": 5539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2822.42, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2822, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3528.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3528, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4985.1, "standard_charge_percentage": 78.5000, "estimated_amount": 4985, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5539, "standard_charge_percentage": 78.5000, "estimated_amount": 5539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5292.04, "standard_charge_percentage": 75.0000, "estimated_amount": 5292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3880.83, "standard_charge_percentage": 55.0000, "estimated_amount": 3880, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6703.25, "standard_charge_percentage": 95.0000, "estimated_amount": 6703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5997.64, "standard_charge_percentage": 85.0000, "estimated_amount": 5997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3528.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3528.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3528, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6350.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5262.05, "standard_charge_percentage": 78.5000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7056.05, "standard_charge_percentage": 100.0000, "estimated_amount": 7056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5483.61, "standard_charge_percentage": 78.5000, "estimated_amount": 5483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5539, "standard_charge_percentage": 78.5000, "estimated_amount": 5539, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6914.93, "standard_charge_percentage": 98.0000, "estimated_amount": 6914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6350.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6174.04, "standard_charge_percentage": 87.5000, "estimated_amount": 6174, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5095.88, "standard_charge_percentage": 78.5000, "estimated_amount": 5095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6350.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Trnk 2.6-7.5 Cm", "code_information": [ { "code": "13101", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23, "discounted_cash": 714,"minimum": 374.23,"maximum": 2036.23,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Trnk Add 5.0 Cm", "code_information": [ { "code": "13102", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23,"minimum": 511,"maximum": 2036.23,"payers_information":[{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Scalp 1.1-2.5 Cm", "code_information": [ { "code": "13120", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 904, "discounted_cash": 714,"minimum": 243.24,"maximum": 904,"payers_information":[{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 768.4, "standard_charge_percentage": 85.0000, "estimated_amount": 768, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 452, "standard_charge_percentage": 50.0000, "estimated_amount": 452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 688.35, "standard_charge_percentage": 78.5000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 858.8, "standard_charge_percentage": 95.0000, "estimated_amount": 858, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 357.98, "standard_charge_percentage": 39.6000, "estimated_amount": 357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 652.87, "standard_charge_percentage": 78.5000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 813.6, "standard_charge_percentage": 90.0000, "estimated_amount": 813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 813.6, "standard_charge_percentage": 90.0000, "estimated_amount": 813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 674.16, "standard_charge_percentage": 78.5000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 678, "standard_charge_percentage": 75.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 791, "standard_charge_percentage": 87.5000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 768.4, "standard_charge_percentage": 85.0000, "estimated_amount": 768, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 702.54, "standard_charge_percentage": 78.5000, "estimated_amount": 702, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 904, "estimated_amount": 904, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 688.35, "standard_charge_percentage": 78.5000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 885.92, "standard_charge_percentage": 98.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 904, "standard_charge_percentage": 100.0000, "estimated_amount": 904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 688.35, "standard_charge_percentage": 78.5000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 674.16, "standard_charge_percentage": 78.5000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 858.8, "standard_charge_percentage": 95.0000, "estimated_amount": 858, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 542.4, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 361.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 452, "standard_charge_percentage": 50.0000, "estimated_amount": 452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 688.35, "standard_charge_percentage": 78.5000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 709.64, "standard_charge_percentage": 78.5000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 638.68, "standard_charge_percentage": 78.5000, "estimated_amount": 638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 497.2, "standard_charge_percentage": 55.0000, "estimated_amount": 497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 709.64, "standard_charge_percentage": 78.5000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 452, "standard_charge_percentage": 50.0000, "estimated_amount": 452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 688.35, "standard_charge_percentage": 78.5000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 709.64, "standard_charge_percentage": 78.5000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 723.2, "standard_charge_percentage": 80.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 271.2, "standard_charge_percentage": 30.0000, "estimated_amount": 271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 813.6, "standard_charge_percentage": 90.0000, "estimated_amount": 813, "methodology": "percent of total billed charges" }]}]} , { "description": "Cmplx rpr sal 2.6-7.5 cm", "code_information": [ { "code": "13121", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1151, "discounted_cash": 714,"minimum": 345.3,"maximum": 1151,"payers_information":[{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 690.6, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 858.36, "standard_charge_percentage": 78.5000, "estimated_amount": 858, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 876.43, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 876.43, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 903.53, "standard_charge_percentage": 78.5000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1093.45, "standard_charge_percentage": 95.0000, "estimated_amount": 1093, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 978.35, "standard_charge_percentage": 85.0000, "estimated_amount": 978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 460.4, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 978.35, "standard_charge_percentage": 85.0000, "estimated_amount": 978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 894.5, "standard_charge_percentage": 78.5000, "estimated_amount": 894, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 455.8, "standard_charge_percentage": 39.6000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1007.13, "standard_charge_percentage": 87.5000, "estimated_amount": 1007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 876.43, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1035.9, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 575.5, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 633.05, "standard_charge_percentage": 55.0000, "estimated_amount": 633, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1035.9, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 575.5, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1151, "standard_charge_percentage": 100.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 831.25, "standard_charge_percentage": 78.5000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 903.53, "standard_charge_percentage": 78.5000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 863.25, "standard_charge_percentage": 75.0000, "estimated_amount": 863, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 903.53, "standard_charge_percentage": 78.5000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 813.18, "standard_charge_percentage": 78.5000, "estimated_amount": 813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 858.36, "standard_charge_percentage": 78.5000, "estimated_amount": 858, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1127.98, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1093.45, "standard_charge_percentage": 95.0000, "estimated_amount": 1093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 575.5, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.3, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1035.9, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 876.43, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.8, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 876.43, "standard_charge_percentage": 78.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Scalp Add 5.0 Cm", "code_information": [ { "code": "13122", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23,"minimum": 511,"maximum": 2036.23,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" }]}]} , { "description": "Cmplx rpr fccmnaxghf", "code_information": [ { "code": "13131", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1034, "discounted_cash": 466,"minimum": 310.2,"maximum": 1034,"payers_information":[{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 811.69, "standard_charge_percentage": 78.5000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 982.3, "standard_charge_percentage": 95.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 878.9, "standard_charge_percentage": 85.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 517, "standard_charge_percentage": 50.0000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 409.46, "standard_charge_percentage": 39.6000, "estimated_amount": 409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1034, "standard_charge_percentage": 100.0000, "estimated_amount": 1034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 904.75, "standard_charge_percentage": 87.5000, "estimated_amount": 904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 787.34, "standard_charge_percentage": 78.5000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 568.7, "standard_charge_percentage": 55.0000, "estimated_amount": 568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 811.69, "standard_charge_percentage": 78.5000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 730.52, "standard_charge_percentage": 78.5000, "estimated_amount": 730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 982.3, "standard_charge_percentage": 95.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 771.11, "standard_charge_percentage": 78.5000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 787.34, "standard_charge_percentage": 78.5000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 803.57, "standard_charge_percentage": 78.5000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 517, "standard_charge_percentage": 50.0000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 310.2, "standard_charge_percentage": 30.0000, "estimated_amount": 310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 878.9, "standard_charge_percentage": 85.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 517, "standard_charge_percentage": 50.0000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 771.11, "standard_charge_percentage": 78.5000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1013.32, "standard_charge_percentage": 98.0000, "estimated_amount": 1013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 620.4, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 620, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 930.6, "standard_charge_percentage": 90.0000, "estimated_amount": 930, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 787.34, "standard_charge_percentage": 78.5000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 811.69, "standard_charge_percentage": 78.5000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 930.6, "standard_charge_percentage": 90.0000, "estimated_amount": 930, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 413.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 930.6, "standard_charge_percentage": 90.0000, "estimated_amount": 930, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 775.5, "standard_charge_percentage": 75.0000, "estimated_amount": 775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 787.34, "standard_charge_percentage": 78.5000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 746.75, "standard_charge_percentage": 78.5000, "estimated_amount": 746, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 827.2, "standard_charge_percentage": 80.0000, "estimated_amount": 827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 787.34, "standard_charge_percentage": 78.5000, "estimated_amount": 787, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Face/Hnd/Ft/Gent 2.6-7.5 Cm", "code_information": [ { "code": "13132", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1419.3, "discounted_cash": 714,"minimum": 374.23,"maximum": 23631.5,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 851.58, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11815.8, "standard_charge_percentage": 50.0000, "estimated_amount": 11815, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 23158.9, "standard_charge_percentage": 98.0000, "estimated_amount": 23158, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 21268.3, "standard_charge_percentage": 90.0000, "estimated_amount": 21268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1206.4, "standard_charge_percentage": 85.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1058.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9358.07, "standard_charge_percentage": 39.6000, "estimated_amount": 9358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7089.45, "standard_charge_percentage": 30.0000, "estimated_amount": 7089, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 709.65, "standard_charge_percentage": 50.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 17623.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1419.3, "standard_charge_percentage": 100.0000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1277.37, "standard_charge_percentage": 90.0000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 18365.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 21268.3, "standard_charge_percentage": 90.0000, "estimated_amount": 21268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1114.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1114, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 18550.7, "standard_charge_percentage": 78.5000, "estimated_amount": 18550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 18550.7, "standard_charge_percentage": 78.5000, "estimated_amount": 18550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 562.04, "standard_charge_percentage": 39.6000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1277.37, "standard_charge_percentage": 90.0000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1277.37, "standard_charge_percentage": 90.0000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1058.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1080.73, "standard_charge_percentage": 78.5000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1206.4, "standard_charge_percentage": 85.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1064.47, "standard_charge_percentage": 75.0000, "estimated_amount": 1064, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17723.6, "standard_charge_percentage": 75.0000, "estimated_amount": 17723, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 20086.8, "standard_charge_percentage": 85.0000, "estimated_amount": 20086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 780.62, "standard_charge_percentage": 55.0000, "estimated_amount": 780, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 16695.7, "standard_charge_percentage": 78.5000, "estimated_amount": 16695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1114.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 18550.7, "standard_charge_percentage": 78.5000, "estimated_amount": 18550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1241.89, "standard_charge_percentage": 87.5000, "estimated_amount": 1241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 709.65, "standard_charge_percentage": 50.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 20677.6, "standard_charge_percentage": 87.5000, "estimated_amount": 20677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1080.73, "standard_charge_percentage": 78.5000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 21268.3, "standard_charge_percentage": 90.0000, "estimated_amount": 21268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1080.73, "standard_charge_percentage": 78.5000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1025.02, "standard_charge_percentage": 78.5000, "estimated_amount": 1025, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12997.3, "standard_charge_percentage": 55.0000, "estimated_amount": 12997, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11815.8, "standard_charge_percentage": 50.0000, "estimated_amount": 11815, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 17066.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1002.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 20086.8, "standard_charge_percentage": 85.0000, "estimated_amount": 20086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11815.8, "standard_charge_percentage": 50.0000, "estimated_amount": 11815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1348.34, "standard_charge_percentage": 95.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1348.34, "standard_charge_percentage": 95.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 17623.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1103.01, "standard_charge_percentage": 78.5000, "estimated_amount": 1103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 425.79, "standard_charge_percentage": 30.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1114.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 22449.9, "standard_charge_percentage": 95.0000, "estimated_amount": 22449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 23631.5, "standard_charge_percentage": 100.0000, "estimated_amount": 23631, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 22449.9, "standard_charge_percentage": 95.0000, "estimated_amount": 22449, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1135.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1390.91, "standard_charge_percentage": 98.0000, "estimated_amount": 1390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1080.73, "standard_charge_percentage": 78.5000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 567.72, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 709.65, "standard_charge_percentage": 50.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1080.73, "standard_charge_percentage": 78.5000, "estimated_amount": 1080, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Face/Hnd/Ft/Gent Ea Add 5.0 Cm", "code_information": [ { "code": "13133", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23,"minimum": 511,"maximum": 2036.23,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Eye/Ear/Nose/Lip 1.1-2.5 Cm", "code_information": [ { "code": "13151", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1547.73, "discounted_cash": 714,"minimum": 325.58,"maximum": 1547.73,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1315.57, "standard_charge_percentage": 85.0000, "estimated_amount": 1315, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1516.78, "standard_charge_percentage": 98.0000, "estimated_amount": 1516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 773.87, "standard_charge_percentage": 50.0000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1093.47, "standard_charge_percentage": 78.5000, "estimated_amount": 1093, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 619.09, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1214.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1214, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1117.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 464.32, "standard_charge_percentage": 30.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1178.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1470.34, "standard_charge_percentage": 95.0000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1178.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1178, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 851.25, "standard_charge_percentage": 55.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1392.96, "standard_charge_percentage": 90.0000, "estimated_amount": 1392, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 773.87, "standard_charge_percentage": 50.0000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1354.26, "standard_charge_percentage": 87.5000, "estimated_amount": 1354, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1214.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1214, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 612.9, "standard_charge_percentage": 39.6000, "estimated_amount": 612, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1315.57, "standard_charge_percentage": 85.0000, "estimated_amount": 1315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 928.64, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1178.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1470.34, "standard_charge_percentage": 95.0000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1178.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1178.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1238.18, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1214.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1214, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 773.87, "standard_charge_percentage": 50.0000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1547.73, "standard_charge_percentage": 100.0000, "estimated_amount": 1547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1202.82, "standard_charge_percentage": 78.5000, "estimated_amount": 1202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1154.22, "standard_charge_percentage": 78.5000, "estimated_amount": 1154, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1392.96, "standard_charge_percentage": 90.0000, "estimated_amount": 1392, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1160.8, "standard_charge_percentage": 75.0000, "estimated_amount": 1160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1392.96, "standard_charge_percentage": 90.0000, "estimated_amount": 1392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1154.22, "standard_charge_percentage": 78.5000, "estimated_amount": 1154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Cplx Eye/Ear/Nose/Lip 2.6-7.5 Cm", "code_information": [ { "code": "13152", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1623, "discounted_cash": 714,"minimum": 374.23,"maximum": 1623,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 973.8, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 973, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1590.54, "standard_charge_percentage": 98.0000, "estimated_amount": 1590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1146.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1217.25, "standard_charge_percentage": 75.0000, "estimated_amount": 1217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1379.55, "standard_charge_percentage": 85.0000, "estimated_amount": 1379, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1420.13, "standard_charge_percentage": 87.5000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1235.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1274.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1274, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1235.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1235.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1210.35, "standard_charge_percentage": 78.5000, "estimated_amount": 1210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1235.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 486.9, "standard_charge_percentage": 30.0000, "estimated_amount": 486, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1541.85, "standard_charge_percentage": 95.0000, "estimated_amount": 1541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1261.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1274.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1274, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 811.5, "standard_charge_percentage": 50.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 811.5, "standard_charge_percentage": 50.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1172.13, "standard_charge_percentage": 78.5000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1541.85, "standard_charge_percentage": 95.0000, "estimated_amount": 1541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 811.5, "standard_charge_percentage": 50.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 892.65, "standard_charge_percentage": 55.0000, "estimated_amount": 892, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1235.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1460.7, "standard_charge_percentage": 90.0000, "estimated_amount": 1460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1460.7, "standard_charge_percentage": 90.0000, "estimated_amount": 1460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1623, "standard_charge_percentage": 100.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1379.55, "standard_charge_percentage": 85.0000, "estimated_amount": 1379, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 649.2, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 649, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1210.35, "standard_charge_percentage": 78.5000, "estimated_amount": 1210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1298.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 642.71, "standard_charge_percentage": 39.6000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1460.7, "standard_charge_percentage": 90.0000, "estimated_amount": 1460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1274.06, "standard_charge_percentage": 78.5000, "estimated_amount": 1274, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Repr Wnd Cplx Eye/Ear/Nose/Lip Ea Add 5.0 Cm", "code_information": [ { "code": "13153", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23,"minimum": 511,"maximum": 2036.23,"payers_information":[{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1465.59, "estimated_amount": 1465, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" }]}]} , { "description": "Sec clsr surg wnddehsn xtn", "code_information": [ { "code": "13160", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20966.6, "discounted_cash": 2136,"minimum": 374.23,"maximum": 20966.6,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 15142.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1081.69, "standard_charge_percentage": 44.4000, "estimated_amount": 1081, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1339.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 20966.6, "standard_charge_percentage": 100.0000, "estimated_amount": 20966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1912.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15965, "standard_charge_percentage": 78.5000, "estimated_amount": 15965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 20547.3, "standard_charge_percentage": 98.0000, "estimated_amount": 20547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2436.23, "estimated_amount": 2436, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10483.3, "standard_charge_percentage": 50.0000, "estimated_amount": 10483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 16294.2, "standard_charge_percentage": 78.5000, "estimated_amount": 16294, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 18345.8, "standard_charge_percentage": 87.5000, "estimated_amount": 18345, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 964.75, "standard_charge_percentage": 39.6000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 16458.8, "standard_charge_percentage": 78.5000, "estimated_amount": 16458, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2314.42, "standard_charge_percentage": 95.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10483.3, "standard_charge_percentage": 50.0000, "estimated_amount": 10483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 17821.6, "standard_charge_percentage": 85.0000, "estimated_amount": 17821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1218.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1721.2, "standard_charge_percentage": 78.5000, "estimated_amount": 1721, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15965, "standard_charge_percentage": 78.5000, "estimated_amount": 15965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2192.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 19918.3, "standard_charge_percentage": 95.0000, "estimated_amount": 19918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 19918.3, "standard_charge_percentage": 95.0000, "estimated_amount": 19918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2070.8, "standard_charge_percentage": 85.0000, "estimated_amount": 2070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1912.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2436.23, "estimated_amount": 2436, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 18869.9, "standard_charge_percentage": 90.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2192.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1893.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11531.6, "standard_charge_percentage": 55.0000, "estimated_amount": 11531, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 15635.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2192.61, "standard_charge_percentage": 90.0000, "estimated_amount": 2192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15965, "standard_charge_percentage": 78.5000, "estimated_amount": 15965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15965, "standard_charge_percentage": 78.5000, "estimated_amount": 15965, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10483.3, "standard_charge_percentage": 50.0000, "estimated_amount": 10483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1461.74, "standard_charge_percentage": 60.0000, "estimated_amount": 1461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2436.23, "estimated_amount": 2436, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 17821.6, "standard_charge_percentage": 85.0000, "estimated_amount": 17821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1218.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15965, "standard_charge_percentage": 78.5000, "estimated_amount": 15965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1855.07, "standard_charge_percentage": 78.5000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2070.8, "standard_charge_percentage": 85.0000, "estimated_amount": 2070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14812.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1912.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8302.77, "standard_charge_percentage": 39.6000, "estimated_amount": 8302, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 16458.8, "standard_charge_percentage": 78.5000, "estimated_amount": 16458, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16458.8, "standard_charge_percentage": 78.5000, "estimated_amount": 16458, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2387.51, "standard_charge_percentage": 98.0000, "estimated_amount": 2387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 18869.9, "standard_charge_percentage": 90.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 15635.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2314.42, "standard_charge_percentage": 95.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1816.82, "standard_charge_percentage": 78.5000, "estimated_amount": 1816, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 730.87, "standard_charge_percentage": 30.0000, "estimated_amount": 730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1759.45, "standard_charge_percentage": 78.5000, "estimated_amount": 1759, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 18869.9, "standard_charge_percentage": 90.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1816.82, "standard_charge_percentage": 78.5000, "estimated_amount": 1816, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6289.98, "standard_charge_percentage": 30.0000, "estimated_amount": 6289, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1827.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2436.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1948.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2131.7, "standard_charge_percentage": 87.5000, "estimated_amount": 2131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 15725, "standard_charge_percentage": 75.0000, "estimated_amount": 15724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1218.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 16773.3, "standard_charge_percentage": 80.0000, "estimated_amount": 16773, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "14000", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7194.52, "discounted_cash": 2136,"minimum": 325.58,"maximum": 7194.52,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6475.07, "standard_charge_percentage": 90.0000, "estimated_amount": 6475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6834.79, "standard_charge_percentage": 95.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 7050.63, "standard_charge_percentage": 98.0000, "estimated_amount": 7050, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6475.07, "standard_charge_percentage": 90.0000, "estimated_amount": 6475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6475.07, "standard_charge_percentage": 90.0000, "estimated_amount": 6475, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5478.27, "standard_charge_percentage": 78.5000, "estimated_amount": 5478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5082.93, "standard_charge_percentage": 78.5000, "estimated_amount": 5082, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5478.27, "standard_charge_percentage": 78.5000, "estimated_amount": 5478, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3597.26, "standard_charge_percentage": 50.0000, "estimated_amount": 3597, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2849.03, "standard_charge_percentage": 39.6000, "estimated_amount": 2849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2877.81, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2877, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5195.88, "standard_charge_percentage": 78.5000, "estimated_amount": 5195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7194.52, "standard_charge_percentage": 100.0000, "estimated_amount": 7194, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5591.22, "standard_charge_percentage": 78.5000, "estimated_amount": 5591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5478.27, "standard_charge_percentage": 78.5000, "estimated_amount": 5478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6115.34, "standard_charge_percentage": 85.0000, "estimated_amount": 6115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5395.89, "standard_charge_percentage": 75.0000, "estimated_amount": 5395, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3597.26, "standard_charge_percentage": 50.0000, "estimated_amount": 3597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6295.2, "standard_charge_percentage": 87.5000, "estimated_amount": 6295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5647.7, "standard_charge_percentage": 78.5000, "estimated_amount": 5647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6834.79, "standard_charge_percentage": 95.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5365.31, "standard_charge_percentage": 78.5000, "estimated_amount": 5365, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3597.26, "standard_charge_percentage": 50.0000, "estimated_amount": 3597, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2158.36, "standard_charge_percentage": 30.0000, "estimated_amount": 2158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5647.7, "standard_charge_percentage": 78.5000, "estimated_amount": 5647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5365.31, "standard_charge_percentage": 78.5000, "estimated_amount": 5365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3956.99, "standard_charge_percentage": 55.0000, "estimated_amount": 3956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5478.27, "standard_charge_percentage": 78.5000, "estimated_amount": 5478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5478.27, "standard_charge_percentage": 78.5000, "estimated_amount": 5478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5647.7, "standard_charge_percentage": 78.5000, "estimated_amount": 5647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6115.34, "standard_charge_percentage": 85.0000, "estimated_amount": 6115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5755.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "14021", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 37781.1, "discounted_cash": 2136,"minimum": 374.23,"maximum": 37781.1,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 28175.3, "standard_charge_percentage": 78.5000, "estimated_amount": 28175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 29658.2, "standard_charge_percentage": 78.5000, "estimated_amount": 29658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 35892.1, "standard_charge_percentage": 95.0000, "estimated_amount": 35892, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 27285.5, "standard_charge_percentage": 78.5000, "estimated_amount": 27285, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 37025.5, "standard_charge_percentage": 98.0000, "estimated_amount": 37025, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 18890.6, "standard_charge_percentage": 50.0000, "estimated_amount": 18890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 34003, "standard_charge_percentage": 90.0000, "estimated_amount": 34003, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 14961.3, "standard_charge_percentage": 39.6000, "estimated_amount": 14961, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 28768.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28768, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 28768.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28768, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 35892.1, "standard_charge_percentage": 95.0000, "estimated_amount": 35892, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 28335.8, "standard_charge_percentage": 75.0000, "estimated_amount": 28335, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 28768.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28768, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 32113.9, "standard_charge_percentage": 85.0000, "estimated_amount": 32113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 34003, "standard_charge_percentage": 90.0000, "estimated_amount": 34003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 29658.2, "standard_charge_percentage": 78.5000, "estimated_amount": 29658, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 28768.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28768, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 29361.6, "standard_charge_percentage": 78.5000, "estimated_amount": 29361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 28175.3, "standard_charge_percentage": 78.5000, "estimated_amount": 28175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 18890.6, "standard_charge_percentage": 50.0000, "estimated_amount": 18890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 33058.5, "standard_charge_percentage": 87.5000, "estimated_amount": 33058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 18890.6, "standard_charge_percentage": 50.0000, "estimated_amount": 18890, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 32113.9, "standard_charge_percentage": 85.0000, "estimated_amount": 32113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 28768.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28768, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 37781.1, "standard_charge_percentage": 100.0000, "estimated_amount": 37781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 34003, "standard_charge_percentage": 90.0000, "estimated_amount": 34003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 30224.9, "standard_charge_percentage": 80.0000, "estimated_amount": 30224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 20779.6, "standard_charge_percentage": 55.0000, "estimated_amount": 20779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11334.3, "standard_charge_percentage": 30.0000, "estimated_amount": 11334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 29658.2, "standard_charge_percentage": 78.5000, "estimated_amount": 29658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 26692.3, "standard_charge_percentage": 78.5000, "estimated_amount": 26692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" }]}]} , { "description": "Hc Adjacent Tissue Trns/Reargmt F/C/C/M/N/A/G/H/F 10Sqcm/&Lt", "code_information": [ { "code": "14040", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2713.26, "discounted_cash": 2136,"minimum": 374.23,"maximum": 36859.6,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1627.96, "standard_charge_percentage": 60.0000, "estimated_amount": 1627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1356.63, "standard_charge_percentage": 50.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2108.61, "standard_charge_percentage": 78.5000, "estimated_amount": 2108, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 28066.7, "standard_charge_percentage": 78.5000, "estimated_amount": 28066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 33173.6, "standard_charge_percentage": 90.0000, "estimated_amount": 33173, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1074.45, "standard_charge_percentage": 39.6000, "estimated_amount": 1074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2129.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2441.93, "standard_charge_percentage": 90.0000, "estimated_amount": 2441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 36859.6, "standard_charge_percentage": 100.0000, "estimated_amount": 36859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1356.63, "standard_charge_percentage": 50.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1916.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 28066.7, "standard_charge_percentage": 78.5000, "estimated_amount": 28066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 18429.8, "standard_charge_percentage": 50.0000, "estimated_amount": 18429, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2023.41, "standard_charge_percentage": 78.5000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 20272.8, "standard_charge_percentage": 55.0000, "estimated_amount": 20272, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2129.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2129, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 28066.7, "standard_charge_percentage": 78.5000, "estimated_amount": 28066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2306.27, "standard_charge_percentage": 85.0000, "estimated_amount": 2306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 27488, "standard_charge_percentage": 78.5000, "estimated_amount": 27488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 28645.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 28066.7, "standard_charge_percentage": 78.5000, "estimated_amount": 28066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 27488, "standard_charge_percentage": 78.5000, "estimated_amount": 27488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2023.41, "standard_charge_percentage": 78.5000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 26620, "standard_charge_percentage": 78.5000, "estimated_amount": 26620, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 35016.6, "standard_charge_percentage": 95.0000, "estimated_amount": 35016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 813.98, "standard_charge_percentage": 30.0000, "estimated_amount": 813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 31330.7, "standard_charge_percentage": 85.0000, "estimated_amount": 31330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 18429.8, "standard_charge_percentage": 50.0000, "estimated_amount": 18429, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 27644.7, "standard_charge_percentage": 75.0000, "estimated_amount": 27644, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2658.99, "standard_charge_percentage": 98.0000, "estimated_amount": 2658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2441.93, "standard_charge_percentage": 90.0000, "estimated_amount": 2441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 14596.4, "standard_charge_percentage": 39.6000, "estimated_amount": 14596, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 36122.4, "standard_charge_percentage": 98.0000, "estimated_amount": 36122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1356.63, "standard_charge_percentage": 50.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2374.1, "standard_charge_percentage": 87.5000, "estimated_amount": 2374, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2034.95, "standard_charge_percentage": 75.0000, "estimated_amount": 2034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28934.8, "standard_charge_percentage": 78.5000, "estimated_amount": 28934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 26041.3, "standard_charge_percentage": 78.5000, "estimated_amount": 26041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1492.29, "standard_charge_percentage": 55.0000, "estimated_amount": 1492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 28934.8, "standard_charge_percentage": 78.5000, "estimated_amount": 28934, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 28934.8, "standard_charge_percentage": 78.5000, "estimated_amount": 28934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2577.6, "standard_charge_percentage": 95.0000, "estimated_amount": 2577, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2713.26, "estimated_amount": 2713, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2713.26, "standard_charge_percentage": 100.0000, "estimated_amount": 2713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 31330.7, "standard_charge_percentage": 85.0000, "estimated_amount": 31330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 18429.8, "standard_charge_percentage": 50.0000, "estimated_amount": 18429, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1959.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2066.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1204.69, "standard_charge_percentage": 44.4000, "estimated_amount": 1204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11057.9, "standard_charge_percentage": 30.0000, "estimated_amount": 11057, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 28066.7, "standard_charge_percentage": 78.5000, "estimated_amount": 28066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2441.93, "standard_charge_percentage": 90.0000, "estimated_amount": 2441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 35016.6, "standard_charge_percentage": 95.0000, "estimated_amount": 35016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 33173.6, "standard_charge_percentage": 90.0000, "estimated_amount": 33173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2577.6, "standard_charge_percentage": 95.0000, "estimated_amount": 2577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 32252.2, "standard_charge_percentage": 87.5000, "estimated_amount": 32252, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2306.27, "standard_charge_percentage": 85.0000, "estimated_amount": 2306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2170.61, "standard_charge_percentage": 80.0000, "estimated_amount": 2170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 29487.7, "standard_charge_percentage": 80.0000, "estimated_amount": 29487, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 33173.6, "standard_charge_percentage": 90.0000, "estimated_amount": 33173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2129.91, "standard_charge_percentage": 78.5000, "estimated_amount": 2129, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "14041", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 17114.6, "discounted_cash": 2136,"minimum": 374.23,"maximum": 17114.6,"payers_information":[{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 13031.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 17114.6, "standard_charge_percentage": 100.0000, "estimated_amount": 17114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 14975.3, "standard_charge_percentage": 87.5000, "estimated_amount": 14975, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 13435, "standard_charge_percentage": 78.5000, "estimated_amount": 13434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 13435, "standard_charge_percentage": 78.5000, "estimated_amount": 13434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 15403.1, "standard_charge_percentage": 90.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 13031.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 13031.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13031, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 8557.3, "standard_charge_percentage": 50.0000, "estimated_amount": 8557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 13031.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 13300.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 12763.2, "standard_charge_percentage": 78.5000, "estimated_amount": 12763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 12763.2, "standard_charge_percentage": 78.5000, "estimated_amount": 12763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 15403.1, "standard_charge_percentage": 90.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 8557.3, "standard_charge_percentage": 50.0000, "estimated_amount": 8557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 12091.5, "standard_charge_percentage": 78.5000, "estimated_amount": 12091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 16258.9, "standard_charge_percentage": 95.0000, "estimated_amount": 16258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 8557.3, "standard_charge_percentage": 50.0000, "estimated_amount": 8557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 12836, "standard_charge_percentage": 75.0000, "estimated_amount": 12835, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 14547.4, "standard_charge_percentage": 85.0000, "estimated_amount": 14547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 13031.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 16258.9, "standard_charge_percentage": 95.0000, "estimated_amount": 16258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 13691.7, "standard_charge_percentage": 80.0000, "estimated_amount": 13691, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 13435, "standard_charge_percentage": 78.5000, "estimated_amount": 13434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 6777.38, "standard_charge_percentage": 39.6000, "estimated_amount": 6777, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 16772.3, "standard_charge_percentage": 98.0000, "estimated_amount": 16772, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 15403.1, "standard_charge_percentage": 90.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 14547.4, "standard_charge_percentage": 85.0000, "estimated_amount": 14547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5134.38, "standard_charge_percentage": 30.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 9413.03, "standard_charge_percentage": 55.0000, "estimated_amount": 9413, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 12360.2, "standard_charge_percentage": 78.5000, "estimated_amount": 12360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" }]}]} , { "description": "Tis trnfr e/n/e/l 10 sq cm/<", "code_information": [ { "code": "14060", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38326.7, "discounted_cash": 2136,"minimum": 374.23,"maximum": 38326.7,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 30086.5, "standard_charge_percentage": 78.5000, "estimated_amount": 30086, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11498, "standard_charge_percentage": 30.0000, "estimated_amount": 11498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 29183.9, "standard_charge_percentage": 78.5000, "estimated_amount": 29183, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 27679.5, "standard_charge_percentage": 78.5000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 19163.3, "standard_charge_percentage": 50.0000, "estimated_amount": 19163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 32577.7, "standard_charge_percentage": 85.0000, "estimated_amount": 32577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 34494, "standard_charge_percentage": 90.0000, "estimated_amount": 34494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 29183.9, "standard_charge_percentage": 78.5000, "estimated_amount": 29183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 29183.9, "standard_charge_percentage": 78.5000, "estimated_amount": 29183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 29183.9, "standard_charge_percentage": 78.5000, "estimated_amount": 29183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 34494, "standard_charge_percentage": 90.0000, "estimated_amount": 34494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 27077.8, "standard_charge_percentage": 78.5000, "estimated_amount": 27077, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 36410.4, "standard_charge_percentage": 95.0000, "estimated_amount": 36410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 30086.5, "standard_charge_percentage": 78.5000, "estimated_amount": 30086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 28745, "standard_charge_percentage": 75.0000, "estimated_amount": 28745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 30086.5, "standard_charge_percentage": 78.5000, "estimated_amount": 30086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 29785.6, "standard_charge_percentage": 78.5000, "estimated_amount": 29785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 19163.3, "standard_charge_percentage": 50.0000, "estimated_amount": 19163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 29183.9, "standard_charge_percentage": 78.5000, "estimated_amount": 29183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 34494, "standard_charge_percentage": 90.0000, "estimated_amount": 34494, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 28582.1, "standard_charge_percentage": 78.5000, "estimated_amount": 28582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 37560.2, "standard_charge_percentage": 98.0000, "estimated_amount": 37560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 28582.1, "standard_charge_percentage": 78.5000, "estimated_amount": 28582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 19163.3, "standard_charge_percentage": 50.0000, "estimated_amount": 19163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 21079.7, "standard_charge_percentage": 55.0000, "estimated_amount": 21079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 33535.9, "standard_charge_percentage": 87.5000, "estimated_amount": 33535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 36410.4, "standard_charge_percentage": 95.0000, "estimated_amount": 36410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 30661.4, "standard_charge_percentage": 80.0000, "estimated_amount": 30661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 32577.7, "standard_charge_percentage": 85.0000, "estimated_amount": 32577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15177.4, "standard_charge_percentage": 39.6000, "estimated_amount": 15177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 38326.7, "standard_charge_percentage": 100.0000, "estimated_amount": 38326, "methodology": "percent of total billed charges" }]}]} , { "description": "Tis trnfr e/n/e/l10.1-30sqcm", "code_information": [ { "code": "14061", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 39005.2, "discounted_cash": 2136,"minimum": 374.23,"maximum": 39005.2,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 39005.2, "standard_charge_percentage": 100.0000, "estimated_amount": 39005, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 30619.1, "standard_charge_percentage": 78.5000, "estimated_amount": 30619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 30619.1, "standard_charge_percentage": 78.5000, "estimated_amount": 30619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 34129.6, "standard_charge_percentage": 87.5000, "estimated_amount": 34129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11701.6, "standard_charge_percentage": 30.0000, "estimated_amount": 11701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 29700.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15446.1, "standard_charge_percentage": 39.6000, "estimated_amount": 15446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 29088.1, "standard_charge_percentage": 78.5000, "estimated_amount": 29088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 30619.1, "standard_charge_percentage": 78.5000, "estimated_amount": 30619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 19502.6, "standard_charge_percentage": 50.0000, "estimated_amount": 19502, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 30312.9, "standard_charge_percentage": 78.5000, "estimated_amount": 30312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 27557.2, "standard_charge_percentage": 78.5000, "estimated_amount": 27557, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 28169.6, "standard_charge_percentage": 78.5000, "estimated_amount": 28169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 35104.7, "standard_charge_percentage": 90.0000, "estimated_amount": 35104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 21452.9, "standard_charge_percentage": 55.0000, "estimated_amount": 21452, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 19502.6, "standard_charge_percentage": 50.0000, "estimated_amount": 19502, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 29253.9, "standard_charge_percentage": 75.0000, "estimated_amount": 29253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 38225.1, "standard_charge_percentage": 98.0000, "estimated_amount": 38225, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 29700.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 35104.7, "standard_charge_percentage": 90.0000, "estimated_amount": 35104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 29700.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29700, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 29700.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 29088.1, "standard_charge_percentage": 78.5000, "estimated_amount": 29088, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 35104.7, "standard_charge_percentage": 90.0000, "estimated_amount": 35104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 33154.4, "standard_charge_percentage": 85.0000, "estimated_amount": 33154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 19502.6, "standard_charge_percentage": 50.0000, "estimated_amount": 19502, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 37054.9, "standard_charge_percentage": 95.0000, "estimated_amount": 37054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 29700.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 37054.9, "standard_charge_percentage": 95.0000, "estimated_amount": 37054, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 33154.4, "standard_charge_percentage": 85.0000, "estimated_amount": 33154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 31204.2, "standard_charge_percentage": 80.0000, "estimated_amount": 31204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "14301", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 26096.1, "discounted_cash": 4275,"minimum": 460.29,"maximum": 26096.1,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 13048, "standard_charge_percentage": 50.0000, "estimated_amount": 13048, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 19461.1, "standard_charge_percentage": 78.5000, "estimated_amount": 19461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 20485.4, "standard_charge_percentage": 78.5000, "estimated_amount": 20485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 6578.16, "estimated_amount": 6578, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 3124.63, "estimated_amount": 3124, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 18846.6, "standard_charge_percentage": 78.5000, "estimated_amount": 18846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 3354.86, "estimated_amount": 3354, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 19870.8, "standard_charge_percentage": 78.5000, "estimated_amount": 19870, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7828.82, "standard_charge_percentage": 30.0000, "estimated_amount": 7828, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 23486.5, "standard_charge_percentage": 90.0000, "estimated_amount": 23486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4604.71, "estimated_amount": 4604, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 22181.7, "standard_charge_percentage": 85.0000, "estimated_amount": 22181, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 3256.19, "estimated_amount": 3256, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 18436.9, "standard_charge_percentage": 78.5000, "estimated_amount": 18436, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 19870.8, "standard_charge_percentage": 78.5000, "estimated_amount": 19870, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 19461.1, "standard_charge_percentage": 78.5000, "estimated_amount": 19461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 5098.07, "estimated_amount": 5098, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 19572, "standard_charge_percentage": 75.0000, "estimated_amount": 19572, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 20485.4, "standard_charge_percentage": 78.5000, "estimated_amount": 20485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 23486.5, "standard_charge_percentage": 90.0000, "estimated_amount": 23486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 20280.5, "standard_charge_percentage": 78.5000, "estimated_amount": 20280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 26096.1, "standard_charge_percentage": 100.0000, "estimated_amount": 26096, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 13048, "standard_charge_percentage": 50.0000, "estimated_amount": 13048, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 3321.97, "estimated_amount": 3321, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 19870.8, "standard_charge_percentage": 78.5000, "estimated_amount": 19870, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 22834, "standard_charge_percentage": 87.5000, "estimated_amount": 22834, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 13048, "standard_charge_percentage": 50.0000, "estimated_amount": 13048, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 23486.5, "standard_charge_percentage": 90.0000, "estimated_amount": 23486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 20485.4, "standard_charge_percentage": 78.5000, "estimated_amount": 20485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 24791.3, "standard_charge_percentage": 95.0000, "estimated_amount": 24791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 24791.3, "standard_charge_percentage": 95.0000, "estimated_amount": 24791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 20876.8, "standard_charge_percentage": 80.0000, "estimated_amount": 20876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 19870.8, "standard_charge_percentage": 78.5000, "estimated_amount": 19870, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 19870.8, "standard_charge_percentage": 78.5000, "estimated_amount": 19870, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 14352.8, "standard_charge_percentage": 55.0000, "estimated_amount": 14352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 5098.07, "estimated_amount": 5098, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 22181.7, "standard_charge_percentage": 85.0000, "estimated_amount": 22181, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 10334, "standard_charge_percentage": 39.6000, "estimated_amount": 10334, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 25574.1, "standard_charge_percentage": 98.0000, "estimated_amount": 25574, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "14302", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5294.31,"minimum": 511,"maximum": 5294.31,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5029.59, "standard_charge_percentage": 95.0000, "estimated_amount": 5029, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3740.43, "standard_charge_percentage": 78.5000, "estimated_amount": 3740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5029.59, "standard_charge_percentage": 95.0000, "estimated_amount": 5029, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4156.03, "standard_charge_percentage": 78.5000, "estimated_amount": 4156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2096.55, "standard_charge_percentage": 39.6000, "estimated_amount": 2096, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3823.55, "standard_charge_percentage": 78.5000, "estimated_amount": 3823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2117.72, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2117, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4500.16, "standard_charge_percentage": 85.0000, "estimated_amount": 4500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4764.88, "standard_charge_percentage": 90.0000, "estimated_amount": 4764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1588.29, "standard_charge_percentage": 30.0000, "estimated_amount": 1588, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4031.35, "standard_charge_percentage": 78.5000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2647.16, "standard_charge_percentage": 50.0000, "estimated_amount": 2647, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2647.16, "standard_charge_percentage": 50.0000, "estimated_amount": 2647, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4031.35, "standard_charge_percentage": 78.5000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4031.35, "standard_charge_percentage": 78.5000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4764.88, "standard_charge_percentage": 90.0000, "estimated_amount": 4764, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4764.88, "standard_charge_percentage": 90.0000, "estimated_amount": 4764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3176.59, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3970.73, "standard_charge_percentage": 75.0000, "estimated_amount": 3970, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2911.87, "standard_charge_percentage": 55.0000, "estimated_amount": 2911, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3948.23, "standard_charge_percentage": 78.5000, "estimated_amount": 3948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3948.23, "standard_charge_percentage": 78.5000, "estimated_amount": 3948, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4031.35, "standard_charge_percentage": 78.5000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4156.03, "standard_charge_percentage": 78.5000, "estimated_amount": 4156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4114.47, "standard_charge_percentage": 78.5000, "estimated_amount": 4114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4500.16, "standard_charge_percentage": 85.0000, "estimated_amount": 4500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 5294.31, "standard_charge_percentage": 100.0000, "estimated_amount": 5294, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5188.42, "standard_charge_percentage": 98.0000, "estimated_amount": 5188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4031.35, "standard_charge_percentage": 78.5000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4156.03, "standard_charge_percentage": 78.5000, "estimated_amount": 4156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2647.16, "standard_charge_percentage": 50.0000, "estimated_amount": 2647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4632.52, "standard_charge_percentage": 87.5000, "estimated_amount": 4632, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4235.45, "standard_charge_percentage": 80.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" }]}]} , { "description": "Wound prep trkarmleg", "code_information": [ { "code": "15002", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1563.65, "discounted_cash": 2136,"minimum": 325.58,"maximum": 1563.65,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1329.1, "standard_charge_percentage": 85.0000, "estimated_amount": 1329, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1227.47, "standard_charge_percentage": 78.5000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 781.83, "standard_charge_percentage": 50.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1563.65, "standard_charge_percentage": 100.0000, "estimated_amount": 1563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1215.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1215, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 860.01, "standard_charge_percentage": 55.0000, "estimated_amount": 860, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1104.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1190.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1227.47, "standard_charge_percentage": 78.5000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1190.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1190, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1329.1, "standard_charge_percentage": 85.0000, "estimated_amount": 1329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 938.19, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 938, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1166.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 469.1, "standard_charge_percentage": 30.0000, "estimated_amount": 469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1407.29, "standard_charge_percentage": 90.0000, "estimated_amount": 1407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1172.74, "standard_charge_percentage": 75.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 619.21, "standard_charge_percentage": 39.6000, "estimated_amount": 619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 625.46, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1532.38, "standard_charge_percentage": 98.0000, "estimated_amount": 1532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1190.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1368.19, "standard_charge_percentage": 87.5000, "estimated_amount": 1368, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1485.47, "standard_charge_percentage": 95.0000, "estimated_amount": 1485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1166.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1250.92, "standard_charge_percentage": 80.0000, "estimated_amount": 1250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1227.47, "standard_charge_percentage": 78.5000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1190.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1485.47, "standard_charge_percentage": 95.0000, "estimated_amount": 1485, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1407.29, "standard_charge_percentage": 90.0000, "estimated_amount": 1407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1190.64, "standard_charge_percentage": 78.5000, "estimated_amount": 1190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1563.65, "estimated_amount": 1563, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1407.29, "standard_charge_percentage": 90.0000, "estimated_amount": 1407, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 781.83, "standard_charge_percentage": 50.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1129.27, "standard_charge_percentage": 78.5000, "estimated_amount": 1129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 781.83, "standard_charge_percentage": 50.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Prep Wnd Trk/Ar/Lg Ea Add 100 Sqcm Or 1% Peds", "code_information": [ { "code": "15003", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1458,"minimum": 437.4,"maximum": 1458,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1275.75, "standard_charge_percentage": 87.5000, "estimated_amount": 1275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1133.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1030.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1030, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1312.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1087.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1087, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1093.5, "standard_charge_percentage": 75.0000, "estimated_amount": 1093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1458, "standard_charge_percentage": 100.0000, "estimated_amount": 1458, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1110.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1144.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1144, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1239.3, "standard_charge_percentage": 85.0000, "estimated_amount": 1239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1312.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1087.3, "standard_charge_percentage": 78.5000, "estimated_amount": 1087, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1144.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 874.8, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1385.1, "standard_charge_percentage": 95.0000, "estimated_amount": 1385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 583.2, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 583, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 729, "standard_charge_percentage": 50.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 801.9, "standard_charge_percentage": 55.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 729, "standard_charge_percentage": 50.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1428.84, "standard_charge_percentage": 98.0000, "estimated_amount": 1428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1110.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1110.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1312.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 729, "standard_charge_percentage": 50.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1239.3, "standard_charge_percentage": 85.0000, "estimated_amount": 1239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1110.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1385.1, "standard_charge_percentage": 95.0000, "estimated_amount": 1385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 437.4, "standard_charge_percentage": 30.0000, "estimated_amount": 437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1166.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1052.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1052, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 577.37, "standard_charge_percentage": 39.6000, "estimated_amount": 577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1110.19, "standard_charge_percentage": 78.5000, "estimated_amount": 1110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1144.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1144, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Prep Wnd Head/Hnd/Ft/Gent 100 Sqcm Or 1% Peds", "code_information": [ { "code": "15004", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1619.01, "discounted_cash": 714,"minimum": 325.58,"maximum": 1619.01,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1232.8, "standard_charge_percentage": 78.5000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1270.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1270, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1376.16, "standard_charge_percentage": 85.0000, "estimated_amount": 1376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 971.41, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 971, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 809.5, "standard_charge_percentage": 50.0000, "estimated_amount": 809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 641.13, "standard_charge_percentage": 39.6000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1258.21, "standard_charge_percentage": 78.5000, "estimated_amount": 1258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1270.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1207.38, "standard_charge_percentage": 78.5000, "estimated_amount": 1207, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1232.8, "standard_charge_percentage": 78.5000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1538.06, "standard_charge_percentage": 95.0000, "estimated_amount": 1538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1457.11, "standard_charge_percentage": 90.0000, "estimated_amount": 1457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 809.5, "standard_charge_percentage": 50.0000, "estimated_amount": 809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1457.11, "standard_charge_percentage": 90.0000, "estimated_amount": 1457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1619.01, "standard_charge_percentage": 100.0000, "estimated_amount": 1619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1538.06, "standard_charge_percentage": 95.0000, "estimated_amount": 1538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1376.16, "standard_charge_percentage": 85.0000, "estimated_amount": 1376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 809.5, "standard_charge_percentage": 50.0000, "estimated_amount": 809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1586.63, "standard_charge_percentage": 98.0000, "estimated_amount": 1586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1214.26, "standard_charge_percentage": 75.0000, "estimated_amount": 1214, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1169.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 890.46, "standard_charge_percentage": 55.0000, "estimated_amount": 890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 647.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 647, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1457.11, "standard_charge_percentage": 90.0000, "estimated_amount": 1457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1270.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1416.63, "standard_charge_percentage": 87.5000, "estimated_amount": 1416, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1143.83, "standard_charge_percentage": 78.5000, "estimated_amount": 1143, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 485.7, "standard_charge_percentage": 30.0000, "estimated_amount": 485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1232.8, "standard_charge_percentage": 78.5000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1232.8, "standard_charge_percentage": 78.5000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1295.21, "standard_charge_percentage": 80.0000, "estimated_amount": 1295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1207.38, "standard_charge_percentage": 78.5000, "estimated_amount": 1207, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1232.8, "standard_charge_percentage": 78.5000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" }]}]} , { "description": "Hc Prep Wnd Head/Hnd/Ft/Gent Ea Add 100 Sqcm", "code_information": [ { "code": "15005", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1442,"minimum": 432.6,"maximum": 1442,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1098.01, "standard_charge_percentage": 78.5000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1075.37, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1081.5, "standard_charge_percentage": 75.0000, "estimated_amount": 1081, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1369.9, "standard_charge_percentage": 95.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1413.16, "standard_charge_percentage": 98.0000, "estimated_amount": 1413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1120.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1120, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 865.2, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1098.01, "standard_charge_percentage": 78.5000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 721, "standard_charge_percentage": 50.0000, "estimated_amount": 721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1442, "standard_charge_percentage": 100.0000, "estimated_amount": 1442, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1098.01, "standard_charge_percentage": 78.5000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1018.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 721, "standard_charge_percentage": 50.0000, "estimated_amount": 721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1369.9, "standard_charge_percentage": 95.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 432.6, "standard_charge_percentage": 30.0000, "estimated_amount": 432, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1041.41, "standard_charge_percentage": 78.5000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1075.37, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1261.75, "standard_charge_percentage": 87.5000, "estimated_amount": 1261, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 571.03, "standard_charge_percentage": 39.6000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1131.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 576.8, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 576, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1098.01, "standard_charge_percentage": 78.5000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1225.7, "standard_charge_percentage": 85.0000, "estimated_amount": 1225, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1297.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1098.01, "standard_charge_percentage": 78.5000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1297.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1297.8, "standard_charge_percentage": 90.0000, "estimated_amount": 1297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 793.1, "standard_charge_percentage": 55.0000, "estimated_amount": 793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1131.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1131.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 721, "standard_charge_percentage": 50.0000, "estimated_amount": 721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1153.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1225.7, "standard_charge_percentage": 85.0000, "estimated_amount": 1225, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Skin Pinch Graft Procedure <2 Cm", "code_information": [ { "code": "15050", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1611, "discounted_cash": 714,"minimum": 325.58,"maximum": 1611,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1578.78, "standard_charge_percentage": 98.0000, "estimated_amount": 1578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 886.05, "standard_charge_percentage": 55.0000, "estimated_amount": 886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1369.35, "standard_charge_percentage": 85.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 805.5, "standard_charge_percentage": 50.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 966.6, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1201.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1099.88, "estimated_amount": 1099, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1530.45, "standard_charge_percentage": 95.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 522.44, "estimated_amount": 522, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1163.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1611, "standard_charge_percentage": 100.0000, "estimated_amount": 1611, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 637.96, "standard_charge_percentage": 39.6000, "estimated_amount": 637, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 644.4, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1264.63, "standard_charge_percentage": 78.5000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 544.44, "estimated_amount": 544, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1208.25, "standard_charge_percentage": 75.0000, "estimated_amount": 1208, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1138.17, "standard_charge_percentage": 78.5000, "estimated_amount": 1138, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 568.36, "estimated_amount": 568, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1530.45, "standard_charge_percentage": 95.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1449.9, "standard_charge_percentage": 90.0000, "estimated_amount": 1449, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1226.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1226, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 805.5, "standard_charge_percentage": 50.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1226.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1226, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1226.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1226, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1449.9, "standard_charge_percentage": 90.0000, "estimated_amount": 1449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1251.99, "standard_charge_percentage": 78.5000, "estimated_amount": 1251, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1449.9, "standard_charge_percentage": 90.0000, "estimated_amount": 1449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 769.92, "estimated_amount": 769, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 483.3, "standard_charge_percentage": 30.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1369.35, "standard_charge_percentage": 85.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 555.44, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1226.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1226, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1201.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 852.41, "estimated_amount": 852, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1226.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1226, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 560.94, "estimated_amount": 560, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 805.5, "standard_charge_percentage": 50.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 549.94, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1264.63, "standard_charge_percentage": 78.5000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1264.63, "standard_charge_percentage": 78.5000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1409.63, "standard_charge_percentage": 87.5000, "estimated_amount": 1409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1288.8, "standard_charge_percentage": 80.0000, "estimated_amount": 1288, "methodology": "percent of total billed charges" }]}]} , { "description": "Splt agrft t/a/l 1st 100sqcm", "code_information": [ { "code": "15100", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 23631.5, "discounted_cash": 2136,"minimum": 325.58,"maximum": 23631.5,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 20677.6, "standard_charge_percentage": 87.5000, "estimated_amount": 20677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17723.6, "standard_charge_percentage": 75.0000, "estimated_amount": 17723, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11815.8, "standard_charge_percentage": 50.0000, "estimated_amount": 11815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 23631.5, "standard_charge_percentage": 100.0000, "estimated_amount": 23631, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 22449.9, "standard_charge_percentage": 95.0000, "estimated_amount": 22449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 18550.7, "standard_charge_percentage": 78.5000, "estimated_amount": 18550, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 18365.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7089.45, "standard_charge_percentage": 30.0000, "estimated_amount": 7089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 17066.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12997.3, "standard_charge_percentage": 55.0000, "estimated_amount": 12997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 21268.3, "standard_charge_percentage": 90.0000, "estimated_amount": 21268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 18550.7, "standard_charge_percentage": 78.5000, "estimated_amount": 18550, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 17623.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17623, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11815.8, "standard_charge_percentage": 50.0000, "estimated_amount": 11815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 21268.3, "standard_charge_percentage": 90.0000, "estimated_amount": 21268, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 23158.9, "standard_charge_percentage": 98.0000, "estimated_amount": 23158, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 21268.3, "standard_charge_percentage": 90.0000, "estimated_amount": 21268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 17623.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 18905.2, "standard_charge_percentage": 80.0000, "estimated_amount": 18905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 20086.8, "standard_charge_percentage": 85.0000, "estimated_amount": 20086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 17994.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11815.8, "standard_charge_percentage": 50.0000, "estimated_amount": 11815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 18550.7, "standard_charge_percentage": 78.5000, "estimated_amount": 18550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 16695.7, "standard_charge_percentage": 78.5000, "estimated_amount": 16695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 22449.9, "standard_charge_percentage": 95.0000, "estimated_amount": 22449, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9358.07, "standard_charge_percentage": 39.6000, "estimated_amount": 9358, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 20086.8, "standard_charge_percentage": 85.0000, "estimated_amount": 20086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" }]}]} , { "description": "Hc Split Grft,Trunk,Arm,Leg Ea 100 Sqcm", "code_information": [ { "code": "15101", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1412.78,"minimum": 423.83,"maximum": 1412.78,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1053.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1053, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1271.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1271.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1271, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 706.39, "standard_charge_percentage": 50.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1412.78, "standard_charge_percentage": 100.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1109.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1342.14, "standard_charge_percentage": 95.0000, "estimated_amount": 1342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1384.52, "standard_charge_percentage": 98.0000, "estimated_amount": 1384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 559.46, "standard_charge_percentage": 39.6000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1412.78, "estimated_amount": 1412, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 706.39, "standard_charge_percentage": 50.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1200.86, "standard_charge_percentage": 85.0000, "estimated_amount": 1200, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1020.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1236.18, "standard_charge_percentage": 87.5000, "estimated_amount": 1236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1109.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1271.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 706.39, "standard_charge_percentage": 50.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1342.14, "standard_charge_percentage": 95.0000, "estimated_amount": 1342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 998.13, "standard_charge_percentage": 78.5000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 423.83, "standard_charge_percentage": 30.0000, "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1053.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1097.94, "standard_charge_percentage": 78.5000, "estimated_amount": 1097, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 847.67, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 777.03, "standard_charge_percentage": 55.0000, "estimated_amount": 777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1109.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1059.59, "standard_charge_percentage": 75.0000, "estimated_amount": 1059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1200.86, "standard_charge_percentage": 85.0000, "estimated_amount": 1200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 565.11, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 565, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Epidrm Autogrft Trnk/Arm/Leg <100 Sqcm", "code_information": [ { "code": "15110", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6594.8, "discounted_cash": 2136,"minimum": 243.24,"maximum": 6594.8,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5176.92, "standard_charge_percentage": 78.5000, "estimated_amount": 5176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4918.07, "standard_charge_percentage": 78.5000, "estimated_amount": 4918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5125.15, "standard_charge_percentage": 78.5000, "estimated_amount": 5125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5770.45, "standard_charge_percentage": 87.5000, "estimated_amount": 5770, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6265.06, "standard_charge_percentage": 95.0000, "estimated_amount": 6265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5021.61, "standard_charge_percentage": 78.5000, "estimated_amount": 5021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4659.23, "standard_charge_percentage": 78.5000, "estimated_amount": 4659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5021.61, "standard_charge_percentage": 78.5000, "estimated_amount": 5021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5935.32, "standard_charge_percentage": 90.0000, "estimated_amount": 5935, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5176.92, "standard_charge_percentage": 78.5000, "estimated_amount": 5176, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5176.92, "standard_charge_percentage": 78.5000, "estimated_amount": 5176, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5021.61, "standard_charge_percentage": 78.5000, "estimated_amount": 5021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3297.4, "standard_charge_percentage": 50.0000, "estimated_amount": 3297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3297.4, "standard_charge_percentage": 50.0000, "estimated_amount": 3297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4946.1, "standard_charge_percentage": 75.0000, "estimated_amount": 4946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2611.54, "standard_charge_percentage": 39.6000, "estimated_amount": 2611, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6594.8, "standard_charge_percentage": 100.0000, "estimated_amount": 6594, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5605.58, "standard_charge_percentage": 85.0000, "estimated_amount": 5605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5605.58, "standard_charge_percentage": 85.0000, "estimated_amount": 5605, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5021.61, "standard_charge_percentage": 78.5000, "estimated_amount": 5021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1978.44, "standard_charge_percentage": 30.0000, "estimated_amount": 1978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2637.92, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2637, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6265.06, "standard_charge_percentage": 95.0000, "estimated_amount": 6265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5021.61, "standard_charge_percentage": 78.5000, "estimated_amount": 5021, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6462.9, "standard_charge_percentage": 98.0000, "estimated_amount": 6462, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4762.76, "standard_charge_percentage": 78.5000, "estimated_amount": 4762, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5935.32, "standard_charge_percentage": 90.0000, "estimated_amount": 5935, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4918.07, "standard_charge_percentage": 78.5000, "estimated_amount": 4918, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3297.4, "standard_charge_percentage": 50.0000, "estimated_amount": 3297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3627.14, "standard_charge_percentage": 55.0000, "estimated_amount": 3627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5275.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5935.32, "standard_charge_percentage": 90.0000, "estimated_amount": 5935, "methodology": "percent of total billed charges" }]}]} , { "description": "INJ NEUROLYT; EPID LUMB/CAUDAL", "code_information": [ { "code": "15111", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 663.33,"minimum": 199,"maximum": 663.33,"payers_information":[{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 331.67, "standard_charge_percentage": 50.0000, "estimated_amount": 331, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 262.68, "standard_charge_percentage": 39.6000, "estimated_amount": 262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 630.16, "standard_charge_percentage": 95.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 468.64, "standard_charge_percentage": 78.5000, "estimated_amount": 468, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 398, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 479.06, "standard_charge_percentage": 78.5000, "estimated_amount": 479, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 497.5, "standard_charge_percentage": 75.0000, "estimated_amount": 497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 494.68, "standard_charge_percentage": 78.5000, "estimated_amount": 494, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 331.67, "standard_charge_percentage": 50.0000, "estimated_amount": 331, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 630.16, "standard_charge_percentage": 95.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 265.33, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 331.67, "standard_charge_percentage": 50.0000, "estimated_amount": 331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 597, "standard_charge_percentage": 90.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 563.83, "standard_charge_percentage": 85.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 505.09, "standard_charge_percentage": 78.5000, "estimated_amount": 505, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 494.68, "standard_charge_percentage": 78.5000, "estimated_amount": 494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 563.83, "standard_charge_percentage": 85.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 505.09, "standard_charge_percentage": 78.5000, "estimated_amount": 505, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 505.09, "standard_charge_percentage": 78.5000, "estimated_amount": 505, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 520.71, "standard_charge_percentage": 78.5000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 505.09, "standard_charge_percentage": 78.5000, "estimated_amount": 505, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 580.41, "standard_charge_percentage": 87.5000, "estimated_amount": 580, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 663.33, "estimated_amount": 663, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 530.66, "standard_charge_percentage": 80.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 597, "standard_charge_percentage": 90.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 663.33, "standard_charge_percentage": 100.0000, "estimated_amount": 663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 520.71, "standard_charge_percentage": 78.5000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 650.06, "standard_charge_percentage": 98.0000, "estimated_amount": 650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 515.51, "standard_charge_percentage": 78.5000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 199, "standard_charge_percentage": 30.0000, "estimated_amount": 199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 364.83, "standard_charge_percentage": 55.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 597, "standard_charge_percentage": 90.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 520.71, "standard_charge_percentage": 78.5000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 505.09, "standard_charge_percentage": 78.5000, "estimated_amount": 505, "methodology": "percent of total billed charges" }]}]} , { "description": "PERCUTANEOUS DISKECTOMY", "code_information": [ { "code": "15115", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4284.78, "discounted_cash": 2136,"minimum": 243.24,"maximum": 4284.78,"payers_information":[{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4284.78, "standard_charge_percentage": 100.0000, "estimated_amount": 4284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4070.54, "standard_charge_percentage": 95.0000, "estimated_amount": 4070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3856.3, "standard_charge_percentage": 90.0000, "estimated_amount": 3856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3094.47, "standard_charge_percentage": 78.5000, "estimated_amount": 3094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3195.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3027.2, "standard_charge_percentage": 78.5000, "estimated_amount": 3027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3329.92, "standard_charge_percentage": 78.5000, "estimated_amount": 3329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3363.55, "standard_charge_percentage": 78.5000, "estimated_amount": 3363, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4199.08, "standard_charge_percentage": 98.0000, "estimated_amount": 4199, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2142.39, "standard_charge_percentage": 50.0000, "estimated_amount": 2142, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1285.43, "standard_charge_percentage": 30.0000, "estimated_amount": 1285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3262.65, "standard_charge_percentage": 78.5000, "estimated_amount": 3262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3262.65, "standard_charge_percentage": 78.5000, "estimated_amount": 3262, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2142.39, "standard_charge_percentage": 50.0000, "estimated_amount": 2142, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3195.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3363.55, "standard_charge_percentage": 78.5000, "estimated_amount": 3363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4070.54, "standard_charge_percentage": 95.0000, "estimated_amount": 4070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3642.06, "standard_charge_percentage": 85.0000, "estimated_amount": 3642, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1696.77, "standard_charge_percentage": 39.6000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3213.59, "standard_charge_percentage": 75.0000, "estimated_amount": 3213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3262.65, "standard_charge_percentage": 78.5000, "estimated_amount": 3262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1713.91, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3363.55, "standard_charge_percentage": 78.5000, "estimated_amount": 3363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2356.63, "standard_charge_percentage": 55.0000, "estimated_amount": 2356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3856.3, "standard_charge_percentage": 90.0000, "estimated_amount": 3856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3262.65, "standard_charge_percentage": 78.5000, "estimated_amount": 3262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3262.65, "standard_charge_percentage": 78.5000, "estimated_amount": 3262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2570.87, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2570, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3427.82, "standard_charge_percentage": 80.0000, "estimated_amount": 3427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3749.18, "standard_charge_percentage": 87.5000, "estimated_amount": 3749, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3642.06, "standard_charge_percentage": 85.0000, "estimated_amount": 3642, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2142.39, "standard_charge_percentage": 50.0000, "estimated_amount": 2142, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3856.3, "standard_charge_percentage": 90.0000, "estimated_amount": 3856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" }]}]} , { "description": "INJECT INTO DISK LESION", "code_information": [ { "code": "15116", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 271.75,"minimum": 81.53,"maximum": 271.75,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 135.88, "standard_charge_percentage": 50.0000, "estimated_amount": 135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 203.81, "standard_charge_percentage": 75.0000, "estimated_amount": 203, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 271.75, "standard_charge_percentage": 100.0000, "estimated_amount": 271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 81.53, "standard_charge_percentage": 30.0000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 202.66, "standard_charge_percentage": 78.5000, "estimated_amount": 202, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 206.92, "standard_charge_percentage": 78.5000, "estimated_amount": 206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 206.92, "standard_charge_percentage": 78.5000, "estimated_amount": 206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 206.92, "standard_charge_percentage": 78.5000, "estimated_amount": 206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 163.05, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 108.7, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 108, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 213.32, "standard_charge_percentage": 78.5000, "estimated_amount": 213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 149.46, "standard_charge_percentage": 55.0000, "estimated_amount": 149, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 191.99, "standard_charge_percentage": 78.5000, "estimated_amount": 191, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 202.66, "standard_charge_percentage": 78.5000, "estimated_amount": 202, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 230.99, "standard_charge_percentage": 85.0000, "estimated_amount": 230, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 271.75, "estimated_amount": 271, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 230.99, "standard_charge_percentage": 85.0000, "estimated_amount": 230, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 196.26, "standard_charge_percentage": 78.5000, "estimated_amount": 196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 213.32, "standard_charge_percentage": 78.5000, "estimated_amount": 213, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 271.75, "estimated_amount": 271, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 135.88, "standard_charge_percentage": 50.0000, "estimated_amount": 135, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 266.31, "standard_charge_percentage": 98.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 244.57, "standard_charge_percentage": 90.0000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 237.78, "standard_charge_percentage": 87.5000, "estimated_amount": 237, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 217.4, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 213.32, "standard_charge_percentage": 78.5000, "estimated_amount": 213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 258.16, "standard_charge_percentage": 95.0000, "estimated_amount": 258, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 107.61, "standard_charge_percentage": 39.6000, "estimated_amount": 107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 211.19, "standard_charge_percentage": 78.5000, "estimated_amount": 211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 206.92, "standard_charge_percentage": 78.5000, "estimated_amount": 206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 244.57, "standard_charge_percentage": 90.0000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 244.57, "standard_charge_percentage": 90.0000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 206.92, "standard_charge_percentage": 78.5000, "estimated_amount": 206, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 135.88, "standard_charge_percentage": 50.0000, "estimated_amount": 135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 258.16, "standard_charge_percentage": 95.0000, "estimated_amount": 258, "methodology": "percent of total billed charges" }]}]} , { "description": "Skn splt a-grft facnckhfg", "code_information": [ { "code": "15120", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5651.15, "discounted_cash": 4275,"minimum": 374.23,"maximum": 5651.15,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 3256.19, "estimated_amount": 3256, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2825.57, "standard_charge_percentage": 50.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5086.03, "standard_charge_percentage": 90.0000, "estimated_amount": 5086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5368.59, "standard_charge_percentage": 95.0000, "estimated_amount": 5368, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2825.57, "standard_charge_percentage": 50.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2825.57, "standard_charge_percentage": 50.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4436.15, "standard_charge_percentage": 78.5000, "estimated_amount": 4436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4303.07, "standard_charge_percentage": 78.5000, "estimated_amount": 4303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4944.76, "standard_charge_percentage": 87.5000, "estimated_amount": 4944, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4803.48, "standard_charge_percentage": 85.0000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 3321.97, "estimated_amount": 3321, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4436.15, "standard_charge_percentage": 78.5000, "estimated_amount": 4436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5368.59, "standard_charge_percentage": 95.0000, "estimated_amount": 5368, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 5098.07, "estimated_amount": 5098, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 3124.63, "estimated_amount": 3124, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3992.54, "standard_charge_percentage": 78.5000, "estimated_amount": 3992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4214.35, "standard_charge_percentage": 78.5000, "estimated_amount": 4214, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1695.35, "standard_charge_percentage": 30.0000, "estimated_amount": 1695, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2237.86, "standard_charge_percentage": 39.6000, "estimated_amount": 2237, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5086.03, "standard_charge_percentage": 90.0000, "estimated_amount": 5086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4214.35, "standard_charge_percentage": 78.5000, "estimated_amount": 4214, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 5098.07, "estimated_amount": 5098, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4303.07, "standard_charge_percentage": 78.5000, "estimated_amount": 4303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5086.03, "standard_charge_percentage": 90.0000, "estimated_amount": 5086, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3390.69, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3108.13, "standard_charge_percentage": 55.0000, "estimated_amount": 3108, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4391.79, "standard_charge_percentage": 78.5000, "estimated_amount": 4391, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4604.71, "estimated_amount": 4604, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 5651.15, "standard_charge_percentage": 100.0000, "estimated_amount": 5651, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5651.15, "estimated_amount": 5651, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4436.15, "standard_charge_percentage": 78.5000, "estimated_amount": 4436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4081.26, "standard_charge_percentage": 78.5000, "estimated_amount": 4081, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4303.07, "standard_charge_percentage": 78.5000, "estimated_amount": 4303, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 3354.86, "estimated_amount": 3354, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2260.46, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4303.07, "standard_charge_percentage": 78.5000, "estimated_amount": 4303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4238.36, "standard_charge_percentage": 75.0000, "estimated_amount": 4238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4803.48, "standard_charge_percentage": 85.0000, "estimated_amount": 4803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5538.13, "standard_charge_percentage": 98.0000, "estimated_amount": 5538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4303.07, "standard_charge_percentage": 78.5000, "estimated_amount": 4303, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4520.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Split Grft,Head,Fac,Hand,Feet Ea 100 Sqcm", "code_information": [ { "code": "15121", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1412.78,"minimum": 423.83,"maximum": 1412.78,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 559.46, "standard_charge_percentage": 39.6000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 565.11, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 423.83, "standard_charge_percentage": 30.0000, "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1200.86, "standard_charge_percentage": 85.0000, "estimated_amount": 1200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1271.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1109.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1271.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1271, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1412.78, "estimated_amount": 1412, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 706.39, "standard_charge_percentage": 50.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1342.14, "standard_charge_percentage": 95.0000, "estimated_amount": 1342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1053.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1271.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1412.78, "standard_charge_percentage": 100.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 998.13, "standard_charge_percentage": 78.5000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1059.59, "standard_charge_percentage": 75.0000, "estimated_amount": 1059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1342.14, "standard_charge_percentage": 95.0000, "estimated_amount": 1342, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1097.94, "standard_charge_percentage": 78.5000, "estimated_amount": 1097, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 777.03, "standard_charge_percentage": 55.0000, "estimated_amount": 777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1109.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1020.31, "standard_charge_percentage": 78.5000, "estimated_amount": 1020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1053.58, "standard_charge_percentage": 78.5000, "estimated_amount": 1053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 706.39, "standard_charge_percentage": 50.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1109.03, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1200.86, "standard_charge_percentage": 85.0000, "estimated_amount": 1200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1130.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 706.39, "standard_charge_percentage": 50.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1236.18, "standard_charge_percentage": 87.5000, "estimated_amount": 1236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1075.76, "standard_charge_percentage": 78.5000, "estimated_amount": 1075, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1384.52, "standard_charge_percentage": 98.0000, "estimated_amount": 1384, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 847.67, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 847, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "15220", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18729.7, "discounted_cash": 2136,"minimum": 325.58,"maximum": 18729.7,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16856.8, "standard_charge_percentage": 90.0000, "estimated_amount": 16856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15920.3, "standard_charge_percentage": 85.0000, "estimated_amount": 15920, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18355.2, "standard_charge_percentage": 98.0000, "estimated_amount": 18355, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17793.3, "standard_charge_percentage": 95.0000, "estimated_amount": 17793, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10301.4, "standard_charge_percentage": 55.0000, "estimated_amount": 10301, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16388.5, "standard_charge_percentage": 87.5000, "estimated_amount": 16388, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13967.7, "standard_charge_percentage": 78.5000, "estimated_amount": 13967, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14261.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14261, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7416.98, "standard_charge_percentage": 39.6000, "estimated_amount": 7416, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15920.3, "standard_charge_percentage": 85.0000, "estimated_amount": 15920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14261.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5618.92, "standard_charge_percentage": 30.0000, "estimated_amount": 5618, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14261.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14047.3, "standard_charge_percentage": 75.0000, "estimated_amount": 14047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14702.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14702.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14702, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16856.8, "standard_charge_percentage": 90.0000, "estimated_amount": 16856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16856.8, "standard_charge_percentage": 90.0000, "estimated_amount": 16856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9364.87, "standard_charge_percentage": 50.0000, "estimated_amount": 9364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18729.7, "standard_charge_percentage": 100.0000, "estimated_amount": 18729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13967.7, "standard_charge_percentage": 78.5000, "estimated_amount": 13967, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13232.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14702.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14261.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17793.3, "standard_charge_percentage": 95.0000, "estimated_amount": 17793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14983.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14983, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9364.87, "standard_charge_percentage": 50.0000, "estimated_amount": 9364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14555.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14555, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9364.87, "standard_charge_percentage": 50.0000, "estimated_amount": 9364, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14261.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13526.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13526, "methodology": "percent of total billed charges" }]}]} , { "description": "Fth gr fr fccmnaxghf", "code_information": [ { "code": "15240", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 14995.3, "discounted_cash": 2136,"minimum": 374.23,"maximum": 14995.3,"payers_information":[{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 13495.8, "standard_charge_percentage": 90.0000, "estimated_amount": 13495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 11771.3, "standard_charge_percentage": 78.5000, "estimated_amount": 11771, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 11418.2, "standard_charge_percentage": 78.5000, "estimated_amount": 11418, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 11418.2, "standard_charge_percentage": 78.5000, "estimated_amount": 11418, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 12746, "standard_charge_percentage": 85.0000, "estimated_amount": 12746, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 14245.5, "standard_charge_percentage": 95.0000, "estimated_amount": 14245, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 14245.5, "standard_charge_percentage": 95.0000, "estimated_amount": 14245, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 7497.65, "standard_charge_percentage": 50.0000, "estimated_amount": 7497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 7497.65, "standard_charge_percentage": 50.0000, "estimated_amount": 7497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 14995.3, "standard_charge_percentage": 100.0000, "estimated_amount": 14995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 11246.5, "standard_charge_percentage": 75.0000, "estimated_amount": 11246, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 11182.8, "standard_charge_percentage": 78.5000, "estimated_amount": 11182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 11771.3, "standard_charge_percentage": 78.5000, "estimated_amount": 11771, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4498.59, "standard_charge_percentage": 30.0000, "estimated_amount": 4498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 11182.8, "standard_charge_percentage": 78.5000, "estimated_amount": 11182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 11771.3, "standard_charge_percentage": 78.5000, "estimated_amount": 11771, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 10594.2, "standard_charge_percentage": 78.5000, "estimated_amount": 10594, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 12746, "standard_charge_percentage": 85.0000, "estimated_amount": 12746, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 14695.4, "standard_charge_percentage": 98.0000, "estimated_amount": 14695, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 11418.2, "standard_charge_percentage": 78.5000, "estimated_amount": 11418, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 5938.14, "standard_charge_percentage": 39.6000, "estimated_amount": 5938, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 13495.8, "standard_charge_percentage": 90.0000, "estimated_amount": 13495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 7497.65, "standard_charge_percentage": 50.0000, "estimated_amount": 7497, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 13120.9, "standard_charge_percentage": 87.5000, "estimated_amount": 13120, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 11418.2, "standard_charge_percentage": 78.5000, "estimated_amount": 11418, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 11653.6, "standard_charge_percentage": 78.5000, "estimated_amount": 11653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 11418.2, "standard_charge_percentage": 78.5000, "estimated_amount": 11418, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 10829.6, "standard_charge_percentage": 78.5000, "estimated_amount": 10829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 8247.42, "standard_charge_percentage": 55.0000, "estimated_amount": 8247, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 13495.8, "standard_charge_percentage": 90.0000, "estimated_amount": 13495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 11996.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11996, "methodology": "percent of total billed charges" }]}]} , { "description": "I&D COMPLEX WOUND INFEC POSTOP", "code_information": [ { "code": "15271", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7682.65, "discounted_cash": 2136,"minimum": 243.24,"maximum": 7682.65,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6914.39, "standard_charge_percentage": 90.0000, "estimated_amount": 6914, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6030.88, "standard_charge_percentage": 78.5000, "estimated_amount": 6030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5729.34, "standard_charge_percentage": 78.5000, "estimated_amount": 5729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6722.32, "standard_charge_percentage": 87.5000, "estimated_amount": 6722, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5427.79, "standard_charge_percentage": 78.5000, "estimated_amount": 5427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3841.32, "standard_charge_percentage": 50.0000, "estimated_amount": 3841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5729.34, "standard_charge_percentage": 78.5000, "estimated_amount": 5729, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5548.41, "standard_charge_percentage": 78.5000, "estimated_amount": 5548, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7682.65, "standard_charge_percentage": 100.0000, "estimated_amount": 7682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6530.25, "standard_charge_percentage": 85.0000, "estimated_amount": 6530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5849.95, "standard_charge_percentage": 78.5000, "estimated_amount": 5849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 7529, "standard_charge_percentage": 98.0000, "estimated_amount": 7529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5849.95, "standard_charge_percentage": 78.5000, "estimated_amount": 5849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5849.95, "standard_charge_percentage": 78.5000, "estimated_amount": 5849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 6030.88, "standard_charge_percentage": 78.5000, "estimated_amount": 6030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 7298.52, "standard_charge_percentage": 95.0000, "estimated_amount": 7298, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5849.95, "standard_charge_percentage": 78.5000, "estimated_amount": 5849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6530.25, "standard_charge_percentage": 85.0000, "estimated_amount": 6530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5849.95, "standard_charge_percentage": 78.5000, "estimated_amount": 5849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6914.39, "standard_charge_percentage": 90.0000, "estimated_amount": 6914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6914.39, "standard_charge_percentage": 90.0000, "estimated_amount": 6914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2304.8, "standard_charge_percentage": 30.0000, "estimated_amount": 2304, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3841.32, "standard_charge_percentage": 50.0000, "estimated_amount": 3841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5761.99, "standard_charge_percentage": 75.0000, "estimated_amount": 5761, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3841.32, "standard_charge_percentage": 50.0000, "estimated_amount": 3841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 7298.52, "standard_charge_percentage": 95.0000, "estimated_amount": 7298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5970.57, "standard_charge_percentage": 78.5000, "estimated_amount": 5970, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 6030.88, "standard_charge_percentage": 78.5000, "estimated_amount": 6030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4225.46, "standard_charge_percentage": 55.0000, "estimated_amount": 4225, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3042.33, "standard_charge_percentage": 39.6000, "estimated_amount": 3042, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3073.06, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3073, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 6146.12, "standard_charge_percentage": 80.0000, "estimated_amount": 6146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" }]}]} , { "description": "D-19 BIOPSY SKIN LESION", "code_information": [ { "code": "15272", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 831.3,"minimum": 249.39,"maximum": 831.3,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 814.67, "standard_charge_percentage": 98.0000, "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 706.61, "standard_charge_percentage": 85.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 329.19, "standard_charge_percentage": 39.6000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 831.3, "estimated_amount": 831, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 632.99, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 831.3, "standard_charge_percentage": 100.0000, "estimated_amount": 831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 498.78, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 249.39, "standard_charge_percentage": 30.0000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 646.04, "standard_charge_percentage": 78.5000, "estimated_amount": 646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 619.94, "standard_charge_percentage": 78.5000, "estimated_amount": 619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 619.94, "standard_charge_percentage": 78.5000, "estimated_amount": 619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 652.57, "standard_charge_percentage": 78.5000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 600.36, "standard_charge_percentage": 78.5000, "estimated_amount": 600, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 415.65, "standard_charge_percentage": 50.0000, "estimated_amount": 415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 789.74, "standard_charge_percentage": 95.0000, "estimated_amount": 789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 623.48, "standard_charge_percentage": 75.0000, "estimated_amount": 623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 632.99, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 457.21, "standard_charge_percentage": 55.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 748.17, "standard_charge_percentage": 90.0000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 748.17, "standard_charge_percentage": 90.0000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 415.65, "standard_charge_percentage": 50.0000, "estimated_amount": 415, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 632.99, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 632.99, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 789.74, "standard_charge_percentage": 95.0000, "estimated_amount": 789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 727.39, "standard_charge_percentage": 87.5000, "estimated_amount": 727, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 748.17, "standard_charge_percentage": 90.0000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 652.57, "standard_charge_percentage": 78.5000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 632.99, "standard_charge_percentage": 78.5000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 652.57, "standard_charge_percentage": 78.5000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 706.61, "standard_charge_percentage": 85.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 415.65, "standard_charge_percentage": 50.0000, "estimated_amount": 415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 665.04, "standard_charge_percentage": 80.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 332.52, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 587.31, "standard_charge_percentage": 78.5000, "estimated_amount": 587, "methodology": "percent of total billed charges" }]}]} , { "description": "D-19 BX SKIN ADDL LESION", "code_information": [ { "code": "15273", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2504.13, "discounted_cash": 4275,"minimum": 243.24,"maximum": 2504.13,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1252.07, "standard_charge_percentage": 50.0000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2191.11, "standard_charge_percentage": 87.5000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 751.24, "standard_charge_percentage": 30.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1965.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1377.27, "standard_charge_percentage": 55.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1906.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2253.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1878.1, "standard_charge_percentage": 75.0000, "estimated_amount": 1878, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2454.05, "standard_charge_percentage": 98.0000, "estimated_amount": 2454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1867.45, "standard_charge_percentage": 78.5000, "estimated_amount": 1867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1906.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1906, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1001.65, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1001, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1808.48, "standard_charge_percentage": 78.5000, "estimated_amount": 1808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2128.51, "standard_charge_percentage": 85.0000, "estimated_amount": 2128, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2378.92, "standard_charge_percentage": 95.0000, "estimated_amount": 2378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1906.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2253.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2253, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 991.64, "standard_charge_percentage": 39.6000, "estimated_amount": 991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1906.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1252.07, "standard_charge_percentage": 50.0000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1965.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1946.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2504.13, "standard_charge_percentage": 100.0000, "estimated_amount": 2504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2378.92, "standard_charge_percentage": 95.0000, "estimated_amount": 2378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1502.48, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1502, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1906.77, "standard_charge_percentage": 78.5000, "estimated_amount": 1906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2128.51, "standard_charge_percentage": 85.0000, "estimated_amount": 2128, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2253.72, "standard_charge_percentage": 90.0000, "estimated_amount": 2253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1769.17, "standard_charge_percentage": 78.5000, "estimated_amount": 1769, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1252.07, "standard_charge_percentage": 50.0000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1965.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1867.45, "standard_charge_percentage": 78.5000, "estimated_amount": 1867, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2504.13, "estimated_amount": 2504, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2003.3, "standard_charge_percentage": 80.0000, "estimated_amount": 2003, "methodology": "percent of total billed charges" }]}]} , { "description": "LIGATURE HEMORRHOIDECTOMY", "code_information": [ { "code": "15274", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2992.42,"minimum": 511,"maximum": 2992.42,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2693.18, "standard_charge_percentage": 90.0000, "estimated_amount": 2693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2231.6, "standard_charge_percentage": 78.5000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2278.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2278, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2693.18, "standard_charge_percentage": 90.0000, "estimated_amount": 2693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2278.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2278, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1496.21, "standard_charge_percentage": 50.0000, "estimated_amount": 1496, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2278.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2278, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1496.21, "standard_charge_percentage": 50.0000, "estimated_amount": 1496, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2349.05, "standard_charge_percentage": 78.5000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2932.57, "standard_charge_percentage": 98.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2618.37, "standard_charge_percentage": 87.5000, "estimated_amount": 2618, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1645.83, "standard_charge_percentage": 55.0000, "estimated_amount": 1645, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2543.56, "standard_charge_percentage": 85.0000, "estimated_amount": 2543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 897.73, "standard_charge_percentage": 30.0000, "estimated_amount": 897, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1795.45, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1795, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2278.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2278, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2349.05, "standard_charge_percentage": 78.5000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2842.8, "standard_charge_percentage": 95.0000, "estimated_amount": 2842, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1185, "standard_charge_percentage": 39.6000, "estimated_amount": 1185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2278.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2278, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2349.05, "standard_charge_percentage": 78.5000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2842.8, "standard_charge_percentage": 95.0000, "estimated_amount": 2842, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2543.56, "standard_charge_percentage": 85.0000, "estimated_amount": 2543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2693.18, "standard_charge_percentage": 90.0000, "estimated_amount": 2693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1196.97, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2325.56, "standard_charge_percentage": 78.5000, "estimated_amount": 2325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2992.42, "standard_charge_percentage": 100.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2114.14, "standard_charge_percentage": 78.5000, "estimated_amount": 2114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2393.94, "standard_charge_percentage": 80.0000, "estimated_amount": 2393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2231.6, "standard_charge_percentage": 78.5000, "estimated_amount": 2231, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1496.21, "standard_charge_percentage": 50.0000, "estimated_amount": 1496, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2161.13, "standard_charge_percentage": 78.5000, "estimated_amount": 2161, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2244.32, "standard_charge_percentage": 75.0000, "estimated_amount": 2244, "methodology": "percent of total billed charges" }]}]} , { "description": "Skin sub graft face/nk/hf/g", "code_information": [ { "code": "15275", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20713.3, "discounted_cash": 2136,"minimum": 243.24,"maximum": 20713.3,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 17606.3, "standard_charge_percentage": 85.0000, "estimated_amount": 17606, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5095.88, "standard_charge_percentage": 78.5000, "estimated_amount": 5095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6350.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15772.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14959.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14959, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 20299, "standard_charge_percentage": 98.0000, "estimated_amount": 20299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6350.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7056.05, "standard_charge_percentage": 100.0000, "estimated_amount": 7056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3528.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3528, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6914.93, "standard_charge_percentage": 98.0000, "estimated_amount": 6914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6174.04, "standard_charge_percentage": 87.5000, "estimated_amount": 6174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 18642, "standard_charge_percentage": 90.0000, "estimated_amount": 18641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4985.1, "standard_charge_percentage": 78.5000, "estimated_amount": 4985, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3528.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5539, "standard_charge_percentage": 78.5000, "estimated_amount": 5539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 15535, "standard_charge_percentage": 75.0000, "estimated_amount": 15534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5292.04, "standard_charge_percentage": 75.0000, "estimated_amount": 5292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10356.7, "standard_charge_percentage": 50.0000, "estimated_amount": 10356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6703.25, "standard_charge_percentage": 95.0000, "estimated_amount": 6703, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16259.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 19677.6, "standard_charge_percentage": 95.0000, "estimated_amount": 19677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14634, "standard_charge_percentage": 78.5000, "estimated_amount": 14633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5997.64, "standard_charge_percentage": 85.0000, "estimated_amount": 5997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6350.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15772.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15772, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 15446.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15446, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15772.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 20713.3, "standard_charge_percentage": 100.0000, "estimated_amount": 20713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 18124.1, "standard_charge_percentage": 87.5000, "estimated_amount": 18124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 18642, "standard_charge_percentage": 90.0000, "estimated_amount": 18641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 19677.6, "standard_charge_percentage": 95.0000, "estimated_amount": 19677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5539, "standard_charge_percentage": 78.5000, "estimated_amount": 5539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6213.99, "standard_charge_percentage": 30.0000, "estimated_amount": 6213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 16097.3, "standard_charge_percentage": 78.5000, "estimated_amount": 16097, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5372.83, "standard_charge_percentage": 78.5000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5539, "standard_charge_percentage": 78.5000, "estimated_amount": 5539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2116.82, "standard_charge_percentage": 30.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 18642, "standard_charge_percentage": 90.0000, "estimated_amount": 18641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5262.05, "standard_charge_percentage": 78.5000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5262.05, "standard_charge_percentage": 78.5000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5997.64, "standard_charge_percentage": 85.0000, "estimated_amount": 5997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 16259.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16259, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2794.2, "standard_charge_percentage": 39.6000, "estimated_amount": 2794, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15772.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8202.47, "standard_charge_percentage": 39.6000, "estimated_amount": 8202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6703.25, "standard_charge_percentage": 95.0000, "estimated_amount": 6703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 17606.3, "standard_charge_percentage": 85.0000, "estimated_amount": 17606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5483.61, "standard_charge_percentage": 78.5000, "estimated_amount": 5483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3880.83, "standard_charge_percentage": 55.0000, "estimated_amount": 3880, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10356.7, "standard_charge_percentage": 50.0000, "estimated_amount": 10356, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3528.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 15446.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2822.42, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 16570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 16570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15772.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11392.3, "standard_charge_percentage": 55.0000, "estimated_amount": 11392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 16259.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10356.7, "standard_charge_percentage": 50.0000, "estimated_amount": 10356, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5644.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" }]}]} , { "description": "ASPIRATE/INJECT THYROID CYST", "code_information": [ { "code": "15276", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 162.05,"minimum": 48.62,"maximum": 162.05,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 121.54, "standard_charge_percentage": 75.0000, "estimated_amount": 121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 141.79, "standard_charge_percentage": 87.5000, "estimated_amount": 141, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 145.85, "standard_charge_percentage": 90.0000, "estimated_amount": 145, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 117.03, "standard_charge_percentage": 78.5000, "estimated_amount": 117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 137.74, "standard_charge_percentage": 85.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 127.21, "standard_charge_percentage": 78.5000, "estimated_amount": 127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 120.85, "standard_charge_percentage": 78.5000, "estimated_amount": 120, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 125.94, "standard_charge_percentage": 78.5000, "estimated_amount": 125, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 64.17, "standard_charge_percentage": 39.6000, "estimated_amount": 64, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 162.05, "estimated_amount": 162, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 81.03, "standard_charge_percentage": 50.0000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 127.21, "standard_charge_percentage": 78.5000, "estimated_amount": 127, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 81.03, "standard_charge_percentage": 50.0000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 137.74, "standard_charge_percentage": 85.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 145.85, "standard_charge_percentage": 90.0000, "estimated_amount": 145, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 145.85, "standard_charge_percentage": 90.0000, "estimated_amount": 145, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 97.23, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 97, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 127.21, "standard_charge_percentage": 78.5000, "estimated_amount": 127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 123.39, "standard_charge_percentage": 78.5000, "estimated_amount": 123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 153.95, "standard_charge_percentage": 95.0000, "estimated_amount": 153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 120.85, "standard_charge_percentage": 78.5000, "estimated_amount": 120, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 153.95, "standard_charge_percentage": 95.0000, "estimated_amount": 153, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 123.39, "standard_charge_percentage": 78.5000, "estimated_amount": 123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 129.64, "standard_charge_percentage": 80.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 64.82, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 64, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 48.62, "standard_charge_percentage": 30.0000, "estimated_amount": 48, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 81.03, "standard_charge_percentage": 50.0000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 123.39, "standard_charge_percentage": 78.5000, "estimated_amount": 123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 123.39, "standard_charge_percentage": 78.5000, "estimated_amount": 123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 123.39, "standard_charge_percentage": 78.5000, "estimated_amount": 123, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 158.81, "standard_charge_percentage": 98.0000, "estimated_amount": 158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 114.49, "standard_charge_percentage": 78.5000, "estimated_amount": 114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 162.05, "standard_charge_percentage": 100.0000, "estimated_amount": 162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 89.13, "standard_charge_percentage": 55.0000, "estimated_amount": 89, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 162.05, "estimated_amount": 162, "methodology": "case rate" }]}]} , { "description": "ASPIRATION/INJECTION THYROID C", "code_information": [ { "code": "15277", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4680.92, "discounted_cash": 2136,"minimum": 1404.28,"maximum": 4680.92,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3564.29, "standard_charge_percentage": 78.5000, "estimated_amount": 3564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3307.07, "standard_charge_percentage": 78.5000, "estimated_amount": 3307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3674.52, "standard_charge_percentage": 78.5000, "estimated_amount": 3674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3637.78, "standard_charge_percentage": 78.5000, "estimated_amount": 3637, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3674.52, "standard_charge_percentage": 78.5000, "estimated_amount": 3674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3564.29, "standard_charge_percentage": 78.5000, "estimated_amount": 3564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3564.29, "standard_charge_percentage": 78.5000, "estimated_amount": 3564, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4212.83, "standard_charge_percentage": 90.0000, "estimated_amount": 4212, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4095.8, "standard_charge_percentage": 87.5000, "estimated_amount": 4095, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2340.46, "standard_charge_percentage": 50.0000, "estimated_amount": 2340, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1853.64, "standard_charge_percentage": 39.6000, "estimated_amount": 1853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3978.78, "standard_charge_percentage": 85.0000, "estimated_amount": 3978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3490.8, "standard_charge_percentage": 78.5000, "estimated_amount": 3490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4587.3, "standard_charge_percentage": 98.0000, "estimated_amount": 4587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4212.83, "standard_charge_percentage": 90.0000, "estimated_amount": 4212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4446.87, "standard_charge_percentage": 95.0000, "estimated_amount": 4446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3564.29, "standard_charge_percentage": 78.5000, "estimated_amount": 3564, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2340.46, "standard_charge_percentage": 50.0000, "estimated_amount": 2340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3380.56, "standard_charge_percentage": 78.5000, "estimated_amount": 3380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3674.52, "standard_charge_percentage": 78.5000, "estimated_amount": 3674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4212.83, "standard_charge_percentage": 90.0000, "estimated_amount": 4212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3490.8, "standard_charge_percentage": 78.5000, "estimated_amount": 3490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3564.29, "standard_charge_percentage": 78.5000, "estimated_amount": 3564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3510.69, "standard_charge_percentage": 75.0000, "estimated_amount": 3510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1404.28, "standard_charge_percentage": 30.0000, "estimated_amount": 1404, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1872.37, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1872, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4680.92, "standard_charge_percentage": 100.0000, "estimated_amount": 4680, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3744.74, "standard_charge_percentage": 80.0000, "estimated_amount": 3744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2808.55, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2574.51, "standard_charge_percentage": 55.0000, "estimated_amount": 2574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2340.46, "standard_charge_percentage": 50.0000, "estimated_amount": 2340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4446.87, "standard_charge_percentage": 95.0000, "estimated_amount": 4446, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3978.78, "standard_charge_percentage": 85.0000, "estimated_amount": 3978, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" }]}]} , { "description": "NEEDLE BX MUSCLE/SOFT TISSUE", "code_information": [ { "code": "15278", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1014.06,"minimum": 304.22,"maximum": 1014.06,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 788.08, "standard_charge_percentage": 78.5000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 756.24, "standard_charge_percentage": 78.5000, "estimated_amount": 756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 861.95, "standard_charge_percentage": 85.0000, "estimated_amount": 861, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 772.16, "standard_charge_percentage": 78.5000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 405.62, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 796.04, "standard_charge_percentage": 78.5000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 507.03, "standard_charge_percentage": 50.0000, "estimated_amount": 507, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 993.78, "standard_charge_percentage": 98.0000, "estimated_amount": 993, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 861.95, "standard_charge_percentage": 85.0000, "estimated_amount": 861, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 963.36, "standard_charge_percentage": 95.0000, "estimated_amount": 963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 760.54, "standard_charge_percentage": 75.0000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1014.06, "standard_charge_percentage": 100.0000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 507.03, "standard_charge_percentage": 50.0000, "estimated_amount": 507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 772.16, "standard_charge_percentage": 78.5000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 732.35, "standard_charge_percentage": 78.5000, "estimated_amount": 732, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 772.16, "standard_charge_percentage": 78.5000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 608.44, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 608, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 772.16, "standard_charge_percentage": 78.5000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 963.36, "standard_charge_percentage": 95.0000, "estimated_amount": 963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 756.24, "standard_charge_percentage": 78.5000, "estimated_amount": 756, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 507.03, "standard_charge_percentage": 50.0000, "estimated_amount": 507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 557.73, "standard_charge_percentage": 55.0000, "estimated_amount": 557, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 401.57, "standard_charge_percentage": 39.6000, "estimated_amount": 401, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 887.3, "standard_charge_percentage": 87.5000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 716.43, "standard_charge_percentage": 78.5000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 912.65, "standard_charge_percentage": 90.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 304.22, "standard_charge_percentage": 30.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 912.65, "standard_charge_percentage": 90.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 772.16, "standard_charge_percentage": 78.5000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1014.06, "estimated_amount": 1014, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 796.04, "standard_charge_percentage": 78.5000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 811.25, "standard_charge_percentage": 80.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 796.04, "standard_charge_percentage": 78.5000, "estimated_amount": 796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 912.65, "standard_charge_percentage": 90.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" }]}]} , { "description": "Revision of lower eyelid", "code_information": [ { "code": "15820", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 44694.5, "discounted_cash": 2136,"minimum": 1477,"maximum": 44694.5,"payers_information":[{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 17699, "standard_charge_percentage": 39.6000, "estimated_amount": 17699, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 40225.1, "standard_charge_percentage": 90.0000, "estimated_amount": 40225, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 33330.9, "standard_charge_percentage": 78.5000, "estimated_amount": 33330, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 37990.3, "standard_charge_percentage": 85.0000, "estimated_amount": 37990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 35085.2, "standard_charge_percentage": 78.5000, "estimated_amount": 35085, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 43800.6, "standard_charge_percentage": 98.0000, "estimated_amount": 43800, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 34032.6, "standard_charge_percentage": 78.5000, "estimated_amount": 34032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 22347.3, "standard_charge_percentage": 50.0000, "estimated_amount": 22347, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 37990.3, "standard_charge_percentage": 85.0000, "estimated_amount": 37990, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 34032.6, "standard_charge_percentage": 78.5000, "estimated_amount": 34032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 40225.1, "standard_charge_percentage": 90.0000, "estimated_amount": 40225, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 34032.6, "standard_charge_percentage": 78.5000, "estimated_amount": 34032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 35085.2, "standard_charge_percentage": 78.5000, "estimated_amount": 35085, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 13408.4, "standard_charge_percentage": 30.0000, "estimated_amount": 13408, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 31576.7, "standard_charge_percentage": 78.5000, "estimated_amount": 31576, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 44694.5, "standard_charge_percentage": 100.0000, "estimated_amount": 44694, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 22347.3, "standard_charge_percentage": 50.0000, "estimated_amount": 22347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 33330.9, "standard_charge_percentage": 78.5000, "estimated_amount": 33330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 24582, "standard_charge_percentage": 55.0000, "estimated_amount": 24581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 40225.1, "standard_charge_percentage": 90.0000, "estimated_amount": 40225, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 39107.7, "standard_charge_percentage": 87.5000, "estimated_amount": 39107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 35085.2, "standard_charge_percentage": 78.5000, "estimated_amount": 35085, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 22347.3, "standard_charge_percentage": 50.0000, "estimated_amount": 22347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 34734.3, "standard_charge_percentage": 78.5000, "estimated_amount": 34734, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 32278.4, "standard_charge_percentage": 78.5000, "estimated_amount": 32278, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 34032.6, "standard_charge_percentage": 78.5000, "estimated_amount": 34032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 33520.9, "standard_charge_percentage": 75.0000, "estimated_amount": 33520, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 34032.6, "standard_charge_percentage": 78.5000, "estimated_amount": 34032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 42459.8, "standard_charge_percentage": 95.0000, "estimated_amount": 42459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 42459.8, "standard_charge_percentage": 95.0000, "estimated_amount": 42459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 35755.6, "standard_charge_percentage": 80.0000, "estimated_amount": 35755, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" }]}]} , { "description": "Revision of upper eyelid", "code_information": [ { "code": "15822", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 41719.1, "discounted_cash": 2136,"minimum": 325.58,"maximum": 41719.1,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 31767, "standard_charge_percentage": 78.5000, "estimated_amount": 31767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 35461.2, "standard_charge_percentage": 85.0000, "estimated_amount": 35461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 39633.1, "standard_charge_percentage": 95.0000, "estimated_amount": 39633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 37547.2, "standard_charge_percentage": 90.0000, "estimated_amount": 37547, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 32422, "standard_charge_percentage": 78.5000, "estimated_amount": 32422, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 31767, "standard_charge_percentage": 78.5000, "estimated_amount": 31767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 41719.1, "standard_charge_percentage": 100.0000, "estimated_amount": 41719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 31767, "standard_charge_percentage": 78.5000, "estimated_amount": 31767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 22945.5, "standard_charge_percentage": 55.0000, "estimated_amount": 22945, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 35461.2, "standard_charge_percentage": 85.0000, "estimated_amount": 35461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 20859.5, "standard_charge_percentage": 50.0000, "estimated_amount": 20859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 32749.5, "standard_charge_percentage": 78.5000, "estimated_amount": 32749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 32749.5, "standard_charge_percentage": 78.5000, "estimated_amount": 32749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 29474.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29474, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 30129.5, "standard_charge_percentage": 78.5000, "estimated_amount": 30129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 16520.8, "standard_charge_percentage": 39.6000, "estimated_amount": 16520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 39633.1, "standard_charge_percentage": 95.0000, "estimated_amount": 39633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 32749.5, "standard_charge_percentage": 78.5000, "estimated_amount": 32749, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 37547.2, "standard_charge_percentage": 90.0000, "estimated_amount": 37547, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 20859.5, "standard_charge_percentage": 50.0000, "estimated_amount": 20859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 36504.2, "standard_charge_percentage": 87.5000, "estimated_amount": 36504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 31112, "standard_charge_percentage": 78.5000, "estimated_amount": 31112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 31112, "standard_charge_percentage": 78.5000, "estimated_amount": 31112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 31767, "standard_charge_percentage": 78.5000, "estimated_amount": 31767, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 40884.7, "standard_charge_percentage": 98.0000, "estimated_amount": 40884, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 12515.7, "standard_charge_percentage": 30.0000, "estimated_amount": 12515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 31289.3, "standard_charge_percentage": 75.0000, "estimated_amount": 31289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 37547.2, "standard_charge_percentage": 90.0000, "estimated_amount": 37547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 31767, "standard_charge_percentage": 78.5000, "estimated_amount": 31767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 20859.5, "standard_charge_percentage": 50.0000, "estimated_amount": 20859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 33375.3, "standard_charge_percentage": 80.0000, "estimated_amount": 33375, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "15823", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38101.6, "discounted_cash": 2136,"minimum": 325.58,"maximum": 38101.6,"payers_information":[{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 28576.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28576, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 37339.6, "standard_charge_percentage": 98.0000, "estimated_amount": 37339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 28414.3, "standard_charge_percentage": 78.5000, "estimated_amount": 28414, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 32386.4, "standard_charge_percentage": 85.0000, "estimated_amount": 32386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 33338.9, "standard_charge_percentage": 87.5000, "estimated_amount": 33338, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 29610.7, "standard_charge_percentage": 78.5000, "estimated_amount": 29610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 32386.4, "standard_charge_percentage": 85.0000, "estimated_amount": 32386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15088.2, "standard_charge_percentage": 39.6000, "estimated_amount": 15088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 20955.9, "standard_charge_percentage": 55.0000, "estimated_amount": 20955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 34291.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 26918.8, "standard_charge_percentage": 78.5000, "estimated_amount": 26918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11430.5, "standard_charge_percentage": 30.0000, "estimated_amount": 11430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 38101.6, "standard_charge_percentage": 100.0000, "estimated_amount": 38101, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3286.82, "estimated_amount": 3286, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 36196.5, "standard_charge_percentage": 95.0000, "estimated_amount": 36196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2547.29, "estimated_amount": 2547, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 28414.3, "standard_charge_percentage": 78.5000, "estimated_amount": 28414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 36196.5, "standard_charge_percentage": 95.0000, "estimated_amount": 36196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 34291.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 27517, "standard_charge_percentage": 78.5000, "estimated_amount": 27516, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2300.77, "estimated_amount": 2300, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 34291.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc skin abd", "code_information": [ { "code": "15830", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 87541.1, "discounted_cash": 7616,"minimum": 374.23,"maximum": 87541.1,"payers_information":[{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 5566.06, "estimated_amount": 5566, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 78787, "standard_charge_percentage": 90.0000, "estimated_amount": 78786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 83164.1, "standard_charge_percentage": 95.0000, "estimated_amount": 83164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 48147.6, "standard_charge_percentage": 55.0000, "estimated_amount": 48147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 85790.3, "standard_charge_percentage": 98.0000, "estimated_amount": 85790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4316, "estimated_amount": 4316, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 5800.42, "estimated_amount": 5800, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 66658.2, "standard_charge_percentage": 78.5000, "estimated_amount": 66658, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 74409.9, "standard_charge_percentage": 85.0000, "estimated_amount": 74409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 66658.2, "standard_charge_percentage": 78.5000, "estimated_amount": 66658, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 63222.2, "standard_charge_percentage": 78.5000, "estimated_amount": 63222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 66658.2, "standard_charge_percentage": 78.5000, "estimated_amount": 66658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8202.61, "estimated_amount": 8202, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 43770.6, "standard_charge_percentage": 50.0000, "estimated_amount": 43770, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 65655.8, "standard_charge_percentage": 75.0000, "estimated_amount": 65655, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 43770.6, "standard_charge_percentage": 50.0000, "estimated_amount": 43770, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 26262.3, "standard_charge_percentage": 30.0000, "estimated_amount": 26262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 74409.9, "standard_charge_percentage": 85.0000, "estimated_amount": 74409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 68032.6, "standard_charge_percentage": 78.5000, "estimated_amount": 68032, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 5917.6, "estimated_amount": 5917, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 5976.19, "estimated_amount": 5976, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 61847.8, "standard_charge_percentage": 78.5000, "estimated_amount": 61847, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 66658.2, "standard_charge_percentage": 78.5000, "estimated_amount": 66658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 83164.1, "standard_charge_percentage": 95.0000, "estimated_amount": 83164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 11718, "estimated_amount": 11718, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 68719.8, "standard_charge_percentage": 78.5000, "estimated_amount": 68719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 68719.8, "standard_charge_percentage": 78.5000, "estimated_amount": 68719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 65283.8, "standard_charge_percentage": 78.5000, "estimated_amount": 65283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 43770.6, "standard_charge_percentage": 50.0000, "estimated_amount": 43770, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 78787, "standard_charge_percentage": 90.0000, "estimated_amount": 78786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 34666.3, "standard_charge_percentage": 39.6000, "estimated_amount": 34666, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 76598.5, "standard_charge_percentage": 87.5000, "estimated_amount": 76598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 87541.1, "standard_charge_percentage": 100.0000, "estimated_amount": 87541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 66658.2, "standard_charge_percentage": 78.5000, "estimated_amount": 66658, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 78787, "standard_charge_percentage": 90.0000, "estimated_amount": 78786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 70032.9, "standard_charge_percentage": 80.0000, "estimated_amount": 70032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 68719.8, "standard_charge_percentage": 78.5000, "estimated_amount": 68719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 65283.8, "standard_charge_percentage": 78.5000, "estimated_amount": 65283, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "15847", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 23091.1,"minimum": 511,"maximum": 23091.1,"payers_information":[{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 19627.4, "standard_charge_percentage": 85.0000, "estimated_amount": 19627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 20204.7, "standard_charge_percentage": 87.5000, "estimated_amount": 20204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 18126.5, "standard_charge_percentage": 78.5000, "estimated_amount": 18126, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17318.3, "standard_charge_percentage": 75.0000, "estimated_amount": 17318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 20782, "standard_charge_percentage": 90.0000, "estimated_amount": 20781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 18126.5, "standard_charge_percentage": 78.5000, "estimated_amount": 18126, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 20782, "standard_charge_percentage": 90.0000, "estimated_amount": 20781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 18126.5, "standard_charge_percentage": 78.5000, "estimated_amount": 18126, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12700.1, "standard_charge_percentage": 55.0000, "estimated_amount": 12700, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 20782, "standard_charge_percentage": 90.0000, "estimated_amount": 20781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 19627.4, "standard_charge_percentage": 85.0000, "estimated_amount": 19627, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11545.5, "standard_charge_percentage": 50.0000, "estimated_amount": 11545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6927.33, "standard_charge_percentage": 30.0000, "estimated_amount": 6927, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9144.08, "standard_charge_percentage": 39.6000, "estimated_amount": 9144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 23091.1, "standard_charge_percentage": 100.0000, "estimated_amount": 23091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16676.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21936.5, "standard_charge_percentage": 95.0000, "estimated_amount": 21936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 21936.5, "standard_charge_percentage": 95.0000, "estimated_amount": 21936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 16313.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16313, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 22629.3, "standard_charge_percentage": 98.0000, "estimated_amount": 22629, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11545.5, "standard_charge_percentage": 50.0000, "estimated_amount": 11545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11545.5, "standard_charge_percentage": 50.0000, "estimated_amount": 11545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 17945.3, "standard_charge_percentage": 78.5000, "estimated_amount": 17945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 17220.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 17220.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "15877", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 23091.1, "discounted_cash": 4275,"minimum": 2255.33,"maximum": 23091.1,"payers_information":[{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 18126.5, "standard_charge_percentage": 78.5000, "estimated_amount": 18126, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2255.33, "estimated_amount": 2255, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 3124.63, "estimated_amount": 3124, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6927.33, "standard_charge_percentage": 30.0000, "estimated_amount": 6927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 16313.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16313, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 18126.5, "standard_charge_percentage": 78.5000, "estimated_amount": 18126, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 20782, "standard_charge_percentage": 90.0000, "estimated_amount": 20781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 20782, "standard_charge_percentage": 90.0000, "estimated_amount": 20781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 6578.16, "estimated_amount": 6578, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 5098.07, "estimated_amount": 5098, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17318.3, "standard_charge_percentage": 75.0000, "estimated_amount": 17318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 23091.1, "standard_charge_percentage": 100.0000, "estimated_amount": 23091, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 20204.7, "standard_charge_percentage": 87.5000, "estimated_amount": 20204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 17220.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11545.5, "standard_charge_percentage": 50.0000, "estimated_amount": 11545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 18126.5, "standard_charge_percentage": 78.5000, "estimated_amount": 18126, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 21936.5, "standard_charge_percentage": 95.0000, "estimated_amount": 21936, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16676.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16676, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9144.08, "standard_charge_percentage": 39.6000, "estimated_amount": 9144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 3256.19, "estimated_amount": 3256, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 19627.4, "standard_charge_percentage": 85.0000, "estimated_amount": 19627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12700.1, "standard_charge_percentage": 55.0000, "estimated_amount": 12700, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11545.5, "standard_charge_percentage": 50.0000, "estimated_amount": 11545, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 17582.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 19627.4, "standard_charge_percentage": 85.0000, "estimated_amount": 19627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 22629.3, "standard_charge_percentage": 98.0000, "estimated_amount": 22629, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 18472.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 17220.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 5098.07, "estimated_amount": 5098, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4604.71, "estimated_amount": 4604, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 17945.3, "standard_charge_percentage": 78.5000, "estimated_amount": 17945, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11545.5, "standard_charge_percentage": 50.0000, "estimated_amount": 11545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 3354.86, "estimated_amount": 3354, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 20782, "standard_charge_percentage": 90.0000, "estimated_amount": 20781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 3321.97, "estimated_amount": 3321, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21936.5, "standard_charge_percentage": 95.0000, "estimated_amount": 21936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Treat Burn 1St Degree, Initial", "code_information": [ { "code": "16000", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 843.4, "discounted_cash": 232,"minimum": 169.58,"maximum": 843.4,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 609.1, "standard_charge_percentage": 78.5000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 628.97, "standard_charge_percentage": 78.5000, "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 801.23, "standard_charge_percentage": 95.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 843.4, "standard_charge_percentage": 100.0000, "estimated_amount": 843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 595.86, "standard_charge_percentage": 78.5000, "estimated_amount": 595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 716.89, "standard_charge_percentage": 85.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 506.04, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 506, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 737.98, "standard_charge_percentage": 87.5000, "estimated_amount": 737, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 333.99, "standard_charge_percentage": 39.6000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 628.97, "standard_charge_percentage": 78.5000, "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 826.53, "standard_charge_percentage": 98.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 716.89, "standard_charge_percentage": 85.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 337.36, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 253.02, "standard_charge_percentage": 30.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 463.87, "standard_charge_percentage": 55.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 632.55, "standard_charge_percentage": 75.0000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 801.23, "standard_charge_percentage": 95.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 655.45, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Dress/Debride Burn <5% Total Sm", "code_information": [ { "code": "16020", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 869.26, "discounted_cash": 232,"minimum": 169.58,"maximum": 869.26,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 869.26, "standard_charge_percentage": 100.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 347.7, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 347, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 648.25, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 651.95, "standard_charge_percentage": 75.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 648.25, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 738.87, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 627.78, "standard_charge_percentage": 78.5000, "estimated_amount": 627, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 825.8, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 521.56, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 738.87, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 675.55, "standard_charge_percentage": 78.5000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 760.6, "standard_charge_percentage": 87.5000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 478.09, "standard_charge_percentage": 55.0000, "estimated_amount": 478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 851.87, "standard_charge_percentage": 98.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 344.23, "standard_charge_percentage": 39.6000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 825.8, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 614.13, "standard_charge_percentage": 78.5000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 260.78, "standard_charge_percentage": 30.0000, "estimated_amount": 260, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Dress/Debride Burn 5-10% Ttl Med", "code_information": [ { "code": "16025", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 843.4, "discounted_cash": 232,"minimum": 169.58,"maximum": 843.4,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 333.99, "standard_charge_percentage": 39.6000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 337.36, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 337, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 238.43, "estimated_amount": 238, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 628.97, "standard_charge_percentage": 78.5000, "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 843.4, "standard_charge_percentage": 100.0000, "estimated_amount": 843, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 826.53, "standard_charge_percentage": 98.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 737.98, "standard_charge_percentage": 87.5000, "estimated_amount": 737, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 801.23, "standard_charge_percentage": 95.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 253.02, "standard_charge_percentage": 30.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 642.21, "standard_charge_percentage": 78.5000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 655.45, "standard_charge_percentage": 78.5000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 628.97, "standard_charge_percentage": 78.5000, "estimated_amount": 628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 716.89, "standard_charge_percentage": 85.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 506.04, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 506, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 632.55, "standard_charge_percentage": 75.0000, "estimated_amount": 632, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 801.23, "standard_charge_percentage": 95.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 609.1, "standard_charge_percentage": 78.5000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 662.07, "standard_charge_percentage": 78.5000, "estimated_amount": 662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 716.89, "standard_charge_percentage": 85.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 759.06, "standard_charge_percentage": 90.0000, "estimated_amount": 759, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 595.86, "standard_charge_percentage": 78.5000, "estimated_amount": 595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 421.7, "standard_charge_percentage": 50.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 463.87, "standard_charge_percentage": 55.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 674.72, "standard_charge_percentage": 80.0000, "estimated_amount": 674, "methodology": "percent of total billed charges" }]}]} , { "description": "Dressdebrid p-thick burn l", "code_information": [ { "code": "16030", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 608.91, "discounted_cash": 466,"minimum": 182.67,"maximum": 608.91,"payers_information":[{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 473.21, "standard_charge_percentage": 78.5000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 334.9, "standard_charge_percentage": 55.0000, "estimated_amount": 334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 548.02, "standard_charge_percentage": 90.0000, "estimated_amount": 548, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 430.19, "standard_charge_percentage": 78.5000, "estimated_amount": 430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 578.46, "standard_charge_percentage": 95.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 463.65, "standard_charge_percentage": 78.5000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 578.46, "standard_charge_percentage": 95.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 477.99, "standard_charge_percentage": 78.5000, "estimated_amount": 477, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 477.99, "standard_charge_percentage": 78.5000, "estimated_amount": 477, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 463.65, "standard_charge_percentage": 78.5000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 304.45, "standard_charge_percentage": 50.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 304.45, "standard_charge_percentage": 50.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 463.65, "standard_charge_percentage": 78.5000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 517.57, "standard_charge_percentage": 85.0000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 596.73, "standard_charge_percentage": 98.0000, "estimated_amount": 596, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 608.91, "standard_charge_percentage": 100.0000, "estimated_amount": 608, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 439.75, "standard_charge_percentage": 78.5000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 243.56, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 463.65, "standard_charge_percentage": 78.5000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 463.65, "standard_charge_percentage": 78.5000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 454.09, "standard_charge_percentage": 78.5000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 517.57, "standard_charge_percentage": 85.0000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 532.8, "standard_charge_percentage": 87.5000, "estimated_amount": 532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 608.91, "estimated_amount": 608, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 182.67, "standard_charge_percentage": 30.0000, "estimated_amount": 182, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 456.68, "standard_charge_percentage": 75.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 241.13, "standard_charge_percentage": 39.6000, "estimated_amount": 241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 454.09, "standard_charge_percentage": 78.5000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 548.02, "standard_charge_percentage": 90.0000, "estimated_amount": 548, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 304.45, "standard_charge_percentage": 50.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 477.99, "standard_charge_percentage": 78.5000, "estimated_amount": 477, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 365.35, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 365, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 487.13, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 548.02, "standard_charge_percentage": 90.0000, "estimated_amount": 548, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Escharotomy", "code_information": [ { "code": "16035", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 923.27, "discounted_cash": 466,"minimum": 276.98,"maximum": 923.27,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 724.77, "standard_charge_percentage": 78.5000, "estimated_amount": 724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 877.11, "standard_charge_percentage": 95.0000, "estimated_amount": 877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 830.94, "standard_charge_percentage": 90.0000, "estimated_amount": 830, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 553.96, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 688.53, "standard_charge_percentage": 78.5000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 666.79, "standard_charge_percentage": 78.5000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 703.02, "standard_charge_percentage": 78.5000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 688.53, "standard_charge_percentage": 78.5000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 703.02, "standard_charge_percentage": 78.5000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 904.8, "standard_charge_percentage": 98.0000, "estimated_amount": 904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 369.31, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 369, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 784.78, "standard_charge_percentage": 85.0000, "estimated_amount": 784, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 365.61, "standard_charge_percentage": 39.6000, "estimated_amount": 365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 703.02, "standard_charge_percentage": 78.5000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 461.63, "standard_charge_percentage": 50.0000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 703.02, "standard_charge_percentage": 78.5000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 507.8, "standard_charge_percentage": 55.0000, "estimated_amount": 507, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 724.77, "standard_charge_percentage": 78.5000, "estimated_amount": 724, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 652.29, "standard_charge_percentage": 78.5000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 807.86, "standard_charge_percentage": 87.5000, "estimated_amount": 807, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 461.63, "standard_charge_percentage": 50.0000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 703.02, "standard_charge_percentage": 78.5000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 724.77, "standard_charge_percentage": 78.5000, "estimated_amount": 724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 923.27, "standard_charge_percentage": 100.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 830.94, "standard_charge_percentage": 90.0000, "estimated_amount": 830, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 276.98, "standard_charge_percentage": 30.0000, "estimated_amount": 276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 784.78, "standard_charge_percentage": 85.0000, "estimated_amount": 784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 692.45, "standard_charge_percentage": 75.0000, "estimated_amount": 692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 461.63, "standard_charge_percentage": 50.0000, "estimated_amount": 461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 717.52, "standard_charge_percentage": 78.5000, "estimated_amount": 717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 830.94, "standard_charge_percentage": 90.0000, "estimated_amount": 830, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 877.11, "standard_charge_percentage": 95.0000, "estimated_amount": 877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 738.62, "standard_charge_percentage": 80.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Destruc Benign/Premal,First Lesion", "code_information": [ { "code": "17000", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 262.59, "discounted_cash": 232,"minimum": 78.78,"maximum": 262.59,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 78.78, "standard_charge_percentage": 30.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 199.95, "standard_charge_percentage": 78.5000, "estimated_amount": 199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 236.33, "standard_charge_percentage": 90.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 131.29, "standard_charge_percentage": 50.0000, "estimated_amount": 131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 199.95, "standard_charge_percentage": 78.5000, "estimated_amount": 199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 199.95, "standard_charge_percentage": 78.5000, "estimated_amount": 199, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 257.34, "standard_charge_percentage": 98.0000, "estimated_amount": 257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 249.46, "standard_charge_percentage": 95.0000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 144.42, "standard_charge_percentage": 55.0000, "estimated_amount": 144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 262.59, "standard_charge_percentage": 100.0000, "estimated_amount": 262, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 131.29, "standard_charge_percentage": 50.0000, "estimated_amount": 131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 262.59, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 229.77, "standard_charge_percentage": 87.5000, "estimated_amount": 229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 206.13, "standard_charge_percentage": 78.5000, "estimated_amount": 206, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 262.59, "estimated_amount": 262, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 262.59, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 223.2, "standard_charge_percentage": 85.0000, "estimated_amount": 223, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 131.29, "standard_charge_percentage": 50.0000, "estimated_amount": 131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 196.94, "standard_charge_percentage": 75.0000, "estimated_amount": 196, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 206.13, "standard_charge_percentage": 78.5000, "estimated_amount": 206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 236.33, "standard_charge_percentage": 90.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 262.59, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 223.2, "standard_charge_percentage": 85.0000, "estimated_amount": 223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 185.52, "standard_charge_percentage": 78.5000, "estimated_amount": 185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 206.13, "standard_charge_percentage": 78.5000, "estimated_amount": 206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 105.04, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 105, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 236.33, "standard_charge_percentage": 90.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 103.99, "standard_charge_percentage": 39.6000, "estimated_amount": 103, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 199.95, "standard_charge_percentage": 78.5000, "estimated_amount": 199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 157.55, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 249.46, "standard_charge_percentage": 95.0000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 195.83, "standard_charge_percentage": 78.5000, "estimated_amount": 195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 199.95, "standard_charge_percentage": 78.5000, "estimated_amount": 199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 204.07, "standard_charge_percentage": 78.5000, "estimated_amount": 204, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 210.07, "standard_charge_percentage": 80.0000, "estimated_amount": 210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 195.83, "standard_charge_percentage": 78.5000, "estimated_amount": 195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 189.64, "standard_charge_percentage": 78.5000, "estimated_amount": 189, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Destruc Benign/Premal,2-14 Lesions", "code_information": [ { "code": "17003", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 104.71,"minimum": 31.41,"maximum": 104.71,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 82.2, "standard_charge_percentage": 78.5000, "estimated_amount": 82, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 52.35, "standard_charge_percentage": 50.0000, "estimated_amount": 52, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 81.38, "standard_charge_percentage": 78.5000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 89, "standard_charge_percentage": 85.0000, "estimated_amount": 89, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 99.47, "standard_charge_percentage": 95.0000, "estimated_amount": 99, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 91.62, "standard_charge_percentage": 87.5000, "estimated_amount": 91, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 79.73, "standard_charge_percentage": 78.5000, "estimated_amount": 79, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 104.71, "estimated_amount": 104, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 79.73, "standard_charge_percentage": 78.5000, "estimated_amount": 79, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 94.24, "standard_charge_percentage": 90.0000, "estimated_amount": 94, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 41.88, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 41, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 104.71, "estimated_amount": 104, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 78.09, "standard_charge_percentage": 78.5000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 82.2, "standard_charge_percentage": 78.5000, "estimated_amount": 82, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 57.59, "standard_charge_percentage": 55.0000, "estimated_amount": 57, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 62.83, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 62, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 52.35, "standard_charge_percentage": 50.0000, "estimated_amount": 52, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 82.2, "standard_charge_percentage": 78.5000, "estimated_amount": 82, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 73.98, "standard_charge_percentage": 78.5000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 102.62, "standard_charge_percentage": 98.0000, "estimated_amount": 102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 31.41, "standard_charge_percentage": 30.0000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 41.47, "standard_charge_percentage": 39.6000, "estimated_amount": 41, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 52.35, "standard_charge_percentage": 50.0000, "estimated_amount": 52, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 94.24, "standard_charge_percentage": 90.0000, "estimated_amount": 94, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 99.47, "standard_charge_percentage": 95.0000, "estimated_amount": 99, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 75.62, "standard_charge_percentage": 78.5000, "estimated_amount": 75, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 104.71, "standard_charge_percentage": 100.0000, "estimated_amount": 104, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 79.73, "standard_charge_percentage": 78.5000, "estimated_amount": 79, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 79.73, "standard_charge_percentage": 78.5000, "estimated_amount": 79, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 94.24, "standard_charge_percentage": 90.0000, "estimated_amount": 94, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 89, "standard_charge_percentage": 85.0000, "estimated_amount": 89, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 78.53, "standard_charge_percentage": 75.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 79.73, "standard_charge_percentage": 78.5000, "estimated_amount": 79, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 83.77, "standard_charge_percentage": 80.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 78.09, "standard_charge_percentage": 78.5000, "estimated_amount": 78, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Destruc Benign/Premal,15+ Lesions", "code_information": [ { "code": "17004", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 817.32, "discounted_cash": 466,"minimum": 208.58,"maximum": 817.32,"payers_information":[{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 245.2, "standard_charge_percentage": 30.0000, "estimated_amount": 245, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 622.35, "standard_charge_percentage": 78.5000, "estimated_amount": 622, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 590.27, "standard_charge_percentage": 78.5000, "estimated_amount": 590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 817.32, "standard_charge_percentage": 100.0000, "estimated_amount": 817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 355.35, "estimated_amount": 355, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 800.97, "standard_charge_percentage": 98.0000, "estimated_amount": 800, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 776.45, "standard_charge_percentage": 95.0000, "estimated_amount": 776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 635.18, "standard_charge_percentage": 78.5000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 556.36, "estimated_amount": 556, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 366.12, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 622.35, "standard_charge_percentage": 78.5000, "estimated_amount": 622, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 502.52, "estimated_amount": 502, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 694.72, "standard_charge_percentage": 85.0000, "estimated_amount": 694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 326.93, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 408.66, "standard_charge_percentage": 50.0000, "estimated_amount": 408, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 408.66, "standard_charge_percentage": 50.0000, "estimated_amount": 408, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 735.59, "standard_charge_percentage": 90.0000, "estimated_amount": 735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 641.6, "standard_charge_percentage": 78.5000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 776.45, "standard_charge_percentage": 95.0000, "estimated_amount": 776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 641.6, "standard_charge_percentage": 78.5000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 717.88, "estimated_amount": 717, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 362.53, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 735.59, "standard_charge_percentage": 90.0000, "estimated_amount": 735, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 323.66, "standard_charge_percentage": 39.6000, "estimated_amount": 323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 340.99, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 612.99, "standard_charge_percentage": 75.0000, "estimated_amount": 612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 490.39, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 715.15, "standard_charge_percentage": 87.5000, "estimated_amount": 715, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 622.35, "standard_charge_percentage": 78.5000, "estimated_amount": 622, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 609.52, "standard_charge_percentage": 78.5000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 622.35, "standard_charge_percentage": 78.5000, "estimated_amount": 622, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 622.35, "standard_charge_percentage": 78.5000, "estimated_amount": 622, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 694.72, "standard_charge_percentage": 85.0000, "estimated_amount": 694, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 609.52, "standard_charge_percentage": 78.5000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 449.53, "standard_charge_percentage": 55.0000, "estimated_amount": 449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 641.6, "standard_charge_percentage": 78.5000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 577.44, "standard_charge_percentage": 78.5000, "estimated_amount": 577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 358.94, "estimated_amount": 358, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 735.59, "standard_charge_percentage": 90.0000, "estimated_amount": 735, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 653.86, "standard_charge_percentage": 80.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 408.66, "standard_charge_percentage": 50.0000, "estimated_amount": 408, "methodology": "percent of total billed charges" }]}]} , { "description": "Destruct b9 lesion 1-14", "code_information": [ { "code": "17110", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19254.2, "discounted_cash": 232,"minimum": 169.58,"maximum": 19254.2,"payers_information":[{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" }]}]} , { "description": "Hc Chem Cautery Granulatn Tissue", "code_information": [ { "code": "17250", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 869.26, "discounted_cash": 232,"minimum": 169.58,"maximum": 869.26,"payers_information":[{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 521.56, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 176.72, "estimated_amount": 176, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 648.25, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 182.08, "estimated_amount": 182, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 208.58, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 869.26, "standard_charge_percentage": 100.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 249.91, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 180.3, "estimated_amount": 180, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 614.13, "standard_charge_percentage": 78.5000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 357.02, "estimated_amount": 357, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 434.63, "standard_charge_percentage": 50.0000, "estimated_amount": 434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 760.6, "standard_charge_percentage": 87.5000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 825.8, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 651.95, "standard_charge_percentage": 75.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 260.78, "standard_charge_percentage": 30.0000, "estimated_amount": 260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 347.7, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 627.78, "standard_charge_percentage": 78.5000, "estimated_amount": 627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 178.51, "estimated_amount": 178, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 276.69, "estimated_amount": 276, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 661.9, "standard_charge_percentage": 78.5000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 851.87, "standard_charge_percentage": 98.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 675.55, "standard_charge_percentage": 78.5000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 695.41, "standard_charge_percentage": 80.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 344.23, "standard_charge_percentage": 39.6000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 738.87, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 825.8, "standard_charge_percentage": 95.0000, "estimated_amount": 825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 682.37, "standard_charge_percentage": 78.5000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 169.58, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 738.87, "standard_charge_percentage": 85.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 478.09, "standard_charge_percentage": 55.0000, "estimated_amount": 478, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 782.33, "standard_charge_percentage": 90.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 648.25, "standard_charge_percentage": 78.5000, "estimated_amount": 648, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc I&D Breast Lesion", "code_information": [ { "code": "19000", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2964.05, "discounted_cash": 821,"minimum": 218.77,"maximum": 2964.05,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2815.85, "standard_charge_percentage": 95.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2519.44, "standard_charge_percentage": 85.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2210.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2094.1, "standard_charge_percentage": 78.5000, "estimated_amount": 2094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1778.43, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2223.04, "standard_charge_percentage": 75.0000, "estimated_amount": 2223, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 889.22, "standard_charge_percentage": 30.0000, "estimated_amount": 889, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2815.85, "standard_charge_percentage": 95.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2593.54, "standard_charge_percentage": 87.5000, "estimated_amount": 2593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 218.77, "estimated_amount": 218, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2303.51, "standard_charge_percentage": 78.5000, "estimated_amount": 2303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 805.47, "estimated_amount": 805, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2964.05, "standard_charge_percentage": 100.0000, "estimated_amount": 2964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1185.62, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1173.76, "standard_charge_percentage": 39.6000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2519.44, "standard_charge_percentage": 85.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2904.77, "standard_charge_percentage": 98.0000, "estimated_amount": 2904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1630.23, "standard_charge_percentage": 55.0000, "estimated_amount": 1630, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2210.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 218.77, "estimated_amount": 218, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2140.64, "standard_charge_percentage": 78.5000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc I&D Breast Lesion Add On", "code_information": [ { "code": "19001", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 424.92,"minimum": 127.48,"maximum": 424.92,"payers_information":[{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 127.48, "standard_charge_percentage": 30.0000, "estimated_amount": 127, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 212.46, "standard_charge_percentage": 50.0000, "estimated_amount": 212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 316.88, "standard_charge_percentage": 78.5000, "estimated_amount": 316, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 361.18, "standard_charge_percentage": 85.0000, "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 330.23, "standard_charge_percentage": 78.5000, "estimated_amount": 330, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 323.56, "standard_charge_percentage": 78.5000, "estimated_amount": 323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 403.67, "standard_charge_percentage": 95.0000, "estimated_amount": 403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 333.56, "standard_charge_percentage": 78.5000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 212.46, "standard_charge_percentage": 50.0000, "estimated_amount": 212, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 382.43, "standard_charge_percentage": 90.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 361.18, "standard_charge_percentage": 85.0000, "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 169.97, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 169, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 233.71, "standard_charge_percentage": 55.0000, "estimated_amount": 233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 323.56, "standard_charge_percentage": 78.5000, "estimated_amount": 323, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 168.27, "standard_charge_percentage": 39.6000, "estimated_amount": 168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 403.67, "standard_charge_percentage": 95.0000, "estimated_amount": 403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 323.56, "standard_charge_percentage": 78.5000, "estimated_amount": 323, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 416.42, "standard_charge_percentage": 98.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 424.92, "estimated_amount": 424, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 300.21, "standard_charge_percentage": 78.5000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 323.56, "standard_charge_percentage": 78.5000, "estimated_amount": 323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 371.81, "standard_charge_percentage": 87.5000, "estimated_amount": 371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 382.43, "standard_charge_percentage": 90.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 323.56, "standard_charge_percentage": 78.5000, "estimated_amount": 323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 424.92, "estimated_amount": 424, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 339.94, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 333.56, "standard_charge_percentage": 78.5000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 212.46, "standard_charge_percentage": 50.0000, "estimated_amount": 212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 318.69, "standard_charge_percentage": 75.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 424.92, "standard_charge_percentage": 100.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 254.95, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 254, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 306.88, "standard_charge_percentage": 78.5000, "estimated_amount": 306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 382.43, "standard_charge_percentage": 90.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 316.88, "standard_charge_percentage": 78.5000, "estimated_amount": 316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 333.56, "standard_charge_percentage": 78.5000, "estimated_amount": 333, "methodology": "percent of total billed charges" }]}]} , { "description": "Mastotomy expl drg absc dp", "code_information": [ { "code": "19020", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3175.45, "discounted_cash": 1892,"minimum": 325.58,"maximum": 3175.45,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2368.09, "standard_charge_percentage": 78.5000, "estimated_amount": 2368, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3175.45, "standard_charge_percentage": 100.0000, "estimated_amount": 3175, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2417.95, "standard_charge_percentage": 78.5000, "estimated_amount": 2417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2857.91, "standard_charge_percentage": 90.0000, "estimated_amount": 2857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2699.13, "standard_charge_percentage": 85.0000, "estimated_amount": 2699, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1784.71, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2293.31, "standard_charge_percentage": 78.5000, "estimated_amount": 2293, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2492.73, "standard_charge_percentage": 78.5000, "estimated_amount": 2492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2467.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2417.95, "standard_charge_percentage": 78.5000, "estimated_amount": 2417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1587.72, "standard_charge_percentage": 50.0000, "estimated_amount": 1587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1746.5, "standard_charge_percentage": 55.0000, "estimated_amount": 1746, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2699.13, "standard_charge_percentage": 85.0000, "estimated_amount": 2699, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3016.68, "standard_charge_percentage": 95.0000, "estimated_amount": 3016, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2857.91, "standard_charge_percentage": 90.0000, "estimated_amount": 2857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2417.95, "standard_charge_percentage": 78.5000, "estimated_amount": 2417, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1905.27, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2368.09, "standard_charge_percentage": 78.5000, "estimated_amount": 2368, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2417.95, "standard_charge_percentage": 78.5000, "estimated_amount": 2417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1270.18, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1270, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3111.94, "standard_charge_percentage": 98.0000, "estimated_amount": 3111, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2857.91, "standard_charge_percentage": 90.0000, "estimated_amount": 2857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 952.63, "standard_charge_percentage": 30.0000, "estimated_amount": 952, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1257.48, "standard_charge_percentage": 39.6000, "estimated_amount": 1257, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1587.72, "standard_charge_percentage": 50.0000, "estimated_amount": 1587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3016.68, "standard_charge_percentage": 95.0000, "estimated_amount": 3016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2417.95, "standard_charge_percentage": 78.5000, "estimated_amount": 2417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2381.59, "standard_charge_percentage": 75.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2540.36, "standard_charge_percentage": 80.0000, "estimated_amount": 2540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2492.73, "standard_charge_percentage": 78.5000, "estimated_amount": 2492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2778.52, "standard_charge_percentage": 87.5000, "estimated_amount": 2778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2492.73, "standard_charge_percentage": 78.5000, "estimated_amount": 2492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2243.46, "standard_charge_percentage": 78.5000, "estimated_amount": 2243, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1587.72, "standard_charge_percentage": 50.0000, "estimated_amount": 1587, "methodology": "percent of total billed charges" }]}]} , { "description": "Bx breast 1st lesion strtctc", "code_information": [ { "code": "19081", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6830.25, "discounted_cash": 1892,"minimum": 286.51,"maximum": 6830.25,"payers_information":[{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2704.78, "standard_charge_percentage": 39.6000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6693.65, "standard_charge_percentage": 98.0000, "estimated_amount": 6693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2049.07, "standard_charge_percentage": 30.0000, "estimated_amount": 2049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1784.71, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4825.57, "standard_charge_percentage": 78.5000, "estimated_amount": 4825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3756.64, "standard_charge_percentage": 55.0000, "estimated_amount": 3756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5308.13, "standard_charge_percentage": 78.5000, "estimated_amount": 5308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4932.81, "standard_charge_percentage": 78.5000, "estimated_amount": 4932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3032.63, "standard_charge_percentage": 44.4000, "estimated_amount": 3032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 4098.15, "standard_charge_percentage": 60.0000, "estimated_amount": 4098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5122.69, "standard_charge_percentage": 75.0000, "estimated_amount": 5122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6830.25, "standard_charge_percentage": 100.0000, "estimated_amount": 6830, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5976.47, "standard_charge_percentage": 87.5000, "estimated_amount": 5976, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Bx Breast W Device Stereotact Guide Addl Lesion", "code_information": [ { "code": "19082", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1528.05,"minimum": 458.42,"maximum": 1528.05,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1199.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1199.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1199, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 764.02, "standard_charge_percentage": 50.0000, "estimated_amount": 764, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1375.24, "standard_charge_percentage": 90.0000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1163.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1163, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1298.84, "standard_charge_percentage": 85.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1187.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1187, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1079.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1451.65, "standard_charge_percentage": 95.0000, "estimated_amount": 1451, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1497.49, "standard_charge_percentage": 98.0000, "estimated_amount": 1497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1451.65, "standard_charge_percentage": 95.0000, "estimated_amount": 1451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1163.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 764.02, "standard_charge_percentage": 50.0000, "estimated_amount": 764, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1199.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 764.02, "standard_charge_percentage": 50.0000, "estimated_amount": 764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1139.54, "standard_charge_percentage": 78.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1337.04, "standard_charge_percentage": 87.5000, "estimated_amount": 1337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 916.83, "standard_charge_percentage": 60.0000, "estimated_amount": 916, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1163.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1298.84, "standard_charge_percentage": 85.0000, "estimated_amount": 1298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1375.24, "standard_charge_percentage": 90.0000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1528.05, "standard_charge_percentage": 100.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 678.45, "standard_charge_percentage": 44.4000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1163.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1163, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1103.56, "standard_charge_percentage": 78.5000, "estimated_amount": 1103, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 605.11, "standard_charge_percentage": 39.6000, "estimated_amount": 605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1146.04, "standard_charge_percentage": 75.0000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1375.24, "standard_charge_percentage": 90.0000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 840.43, "standard_charge_percentage": 55.0000, "estimated_amount": 840, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1222.44, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1139.54, "standard_charge_percentage": 78.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1163.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1163, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1528.05, "estimated_amount": 1528, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 458.42, "standard_charge_percentage": 30.0000, "estimated_amount": 458, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Bx Breast W Device Us Guide 1St Lesion", "code_information": [ { "code": "19083", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6830.25, "discounted_cash": 1892,"minimum": 286.51,"maximum": 6830.25,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5308.13, "standard_charge_percentage": 78.5000, "estimated_amount": 5308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6830.25, "standard_charge_percentage": 100.0000, "estimated_amount": 6830, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2049.07, "standard_charge_percentage": 30.0000, "estimated_amount": 2049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1784.71, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2732.1, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2732, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2704.78, "standard_charge_percentage": 39.6000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4825.57, "standard_charge_percentage": 78.5000, "estimated_amount": 4825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3756.64, "standard_charge_percentage": 55.0000, "estimated_amount": 3756, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4932.81, "standard_charge_percentage": 78.5000, "estimated_amount": 4932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5122.69, "standard_charge_percentage": 75.0000, "estimated_amount": 5122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5976.47, "standard_charge_percentage": 87.5000, "estimated_amount": 5976, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6693.65, "standard_charge_percentage": 98.0000, "estimated_amount": 6693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" }]}]} , { "description": "US TESTICLE SONO", "code_information": [ { "code": "19084", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2860.48,"minimum": 286.51,"maximum": 2860.48,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1716.29, "standard_charge_percentage": 60.0000, "estimated_amount": 1716, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2431.41, "standard_charge_percentage": 85.0000, "estimated_amount": 2431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 858.14, "standard_charge_percentage": 30.0000, "estimated_amount": 858, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2178.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2502.92, "standard_charge_percentage": 87.5000, "estimated_amount": 2502, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2178.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2717.46, "standard_charge_percentage": 95.0000, "estimated_amount": 2717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2178.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2145.36, "standard_charge_percentage": 75.0000, "estimated_amount": 2145, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2574.43, "standard_charge_percentage": 90.0000, "estimated_amount": 2574, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2178.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1430.24, "standard_charge_percentage": 50.0000, "estimated_amount": 1430, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2065.84, "standard_charge_percentage": 78.5000, "estimated_amount": 2065, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2020.93, "standard_charge_percentage": 78.5000, "estimated_amount": 2020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2133.2, "standard_charge_percentage": 78.5000, "estimated_amount": 2133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2803.27, "standard_charge_percentage": 98.0000, "estimated_amount": 2803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1270.05, "standard_charge_percentage": 44.4000, "estimated_amount": 1270, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2431.41, "standard_charge_percentage": 85.0000, "estimated_amount": 2431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2223.02, "standard_charge_percentage": 78.5000, "estimated_amount": 2223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2245.48, "standard_charge_percentage": 78.5000, "estimated_amount": 2245, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2860.48, "standard_charge_percentage": 100.0000, "estimated_amount": 2860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1430.24, "standard_charge_percentage": 50.0000, "estimated_amount": 1430, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2574.43, "standard_charge_percentage": 90.0000, "estimated_amount": 2574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2717.46, "standard_charge_percentage": 95.0000, "estimated_amount": 2717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1573.26, "standard_charge_percentage": 55.0000, "estimated_amount": 1573, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2133.2, "standard_charge_percentage": 78.5000, "estimated_amount": 2133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2245.48, "standard_charge_percentage": 78.5000, "estimated_amount": 2245, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1430.24, "standard_charge_percentage": 50.0000, "estimated_amount": 1430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2245.48, "standard_charge_percentage": 78.5000, "estimated_amount": 2245, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2288.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1784.71, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2574.43, "standard_charge_percentage": 90.0000, "estimated_amount": 2574, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1132.75, "standard_charge_percentage": 39.6000, "estimated_amount": 1132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2178.11, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" }]}]} , { "description": "Bx breast 1st lesion mr imag", "code_information": [ { "code": "19085", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2669, "discounted_cash": 1892,"minimum": 286.51,"maximum": 2669,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2669, "estimated_amount": 2669, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1467.95, "standard_charge_percentage": 55.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2268.65, "standard_charge_percentage": 85.0000, "estimated_amount": 2268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2095.16, "standard_charge_percentage": 78.5000, "estimated_amount": 2095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1334.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2095.16, "standard_charge_percentage": 78.5000, "estimated_amount": 2095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2669, "standard_charge_percentage": 100.0000, "estimated_amount": 2669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2032.31, "standard_charge_percentage": 78.5000, "estimated_amount": 2032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1885.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1885, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1056.92, "standard_charge_percentage": 39.6000, "estimated_amount": 1056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2335.38, "standard_charge_percentage": 87.5000, "estimated_amount": 2335, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2535.55, "standard_charge_percentage": 95.0000, "estimated_amount": 2535, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2032.31, "standard_charge_percentage": 78.5000, "estimated_amount": 2032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2032.31, "standard_charge_percentage": 78.5000, "estimated_amount": 2032, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1334.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1334, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2268.65, "standard_charge_percentage": 85.0000, "estimated_amount": 2268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2535.55, "standard_charge_percentage": 95.0000, "estimated_amount": 2535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2074.21, "standard_charge_percentage": 78.5000, "estimated_amount": 2074, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1927.55, "standard_charge_percentage": 78.5000, "estimated_amount": 1927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1297, "estimated_amount": 1297, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2402.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2095.16, "standard_charge_percentage": 78.5000, "estimated_amount": 2095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2032.31, "standard_charge_percentage": 78.5000, "estimated_amount": 2032, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1334.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1334, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1990.41, "standard_charge_percentage": 78.5000, "estimated_amount": 1990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 800.7, "standard_charge_percentage": 30.0000, "estimated_amount": 800, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2001.75, "standard_charge_percentage": 75.0000, "estimated_amount": 2001, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2402.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1990.41, "standard_charge_percentage": 78.5000, "estimated_amount": 1990, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2402.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2135.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2135, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2032.31, "standard_charge_percentage": 78.5000, "estimated_amount": 2032, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1784.71, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2615.62, "standard_charge_percentage": 98.0000, "estimated_amount": 2615, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1601.4, "standard_charge_percentage": 60.0000, "estimated_amount": 1601, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Bx Breast W Device Mri Guide Addl Lesion", "code_information": [ { "code": "19086", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4513,"minimum": 511,"maximum": 4513,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3365.57, "standard_charge_percentage": 78.5000, "estimated_amount": 3365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4287.35, "standard_charge_percentage": 95.0000, "estimated_amount": 4287, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2256.5, "standard_charge_percentage": 50.0000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3365.57, "standard_charge_percentage": 78.5000, "estimated_amount": 3365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4061.7, "standard_charge_percentage": 90.0000, "estimated_amount": 4061, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2482.15, "standard_charge_percentage": 55.0000, "estimated_amount": 2482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1787.15, "standard_charge_percentage": 39.6000, "estimated_amount": 1787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4061.7, "standard_charge_percentage": 90.0000, "estimated_amount": 4061, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3948.88, "standard_charge_percentage": 87.5000, "estimated_amount": 3948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3436.42, "standard_charge_percentage": 78.5000, "estimated_amount": 3436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3436.42, "standard_charge_percentage": 78.5000, "estimated_amount": 3436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4513, "standard_charge_percentage": 100.0000, "estimated_amount": 4513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3436.42, "standard_charge_percentage": 78.5000, "estimated_amount": 3436, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1784.71, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3384.75, "standard_charge_percentage": 75.0000, "estimated_amount": 3384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1297, "estimated_amount": 1297, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3542.7, "standard_charge_percentage": 78.5000, "estimated_amount": 3542, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3436.42, "standard_charge_percentage": 78.5000, "estimated_amount": 3436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4061.7, "standard_charge_percentage": 90.0000, "estimated_amount": 4061, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4422.74, "standard_charge_percentage": 98.0000, "estimated_amount": 4422, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2707.8, "standard_charge_percentage": 60.0000, "estimated_amount": 2707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3507.28, "standard_charge_percentage": 78.5000, "estimated_amount": 3507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3542.7, "standard_charge_percentage": 78.5000, "estimated_amount": 3542, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3836.05, "standard_charge_percentage": 85.0000, "estimated_amount": 3836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3542.7, "standard_charge_percentage": 78.5000, "estimated_amount": 3542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2256.5, "standard_charge_percentage": 50.0000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2256.5, "standard_charge_percentage": 50.0000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4287.35, "standard_charge_percentage": 95.0000, "estimated_amount": 4287, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3259.29, "standard_charge_percentage": 78.5000, "estimated_amount": 3259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3188.43, "standard_charge_percentage": 78.5000, "estimated_amount": 3188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3436.42, "standard_charge_percentage": 78.5000, "estimated_amount": 3436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1353.9, "standard_charge_percentage": 30.0000, "estimated_amount": 1353, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3836.05, "standard_charge_percentage": 85.0000, "estimated_amount": 3836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3610.4, "standard_charge_percentage": 80.0000, "estimated_amount": 3610, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Bx Breast, Needle Core", "code_information": [ { "code": "19100", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1339.5, "discounted_cash": 1892,"minimum": 243.24,"maximum": 1339.5,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1040.99, "standard_charge_percentage": 78.5000, "estimated_amount": 1040, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1051.51, "standard_charge_percentage": 78.5000, "estimated_amount": 1051, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 669.75, "standard_charge_percentage": 50.0000, "estimated_amount": 669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1051.51, "standard_charge_percentage": 78.5000, "estimated_amount": 1051, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1019.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 401.85, "standard_charge_percentage": 30.0000, "estimated_amount": 401, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1172.06, "standard_charge_percentage": 87.5000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1019.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1019.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 736.73, "standard_charge_percentage": 55.0000, "estimated_amount": 736, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1138.58, "standard_charge_percentage": 85.0000, "estimated_amount": 1138, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 998.93, "standard_charge_percentage": 78.5000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1272.53, "standard_charge_percentage": 95.0000, "estimated_amount": 1272, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1138.58, "standard_charge_percentage": 85.0000, "estimated_amount": 1138, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1004.63, "standard_charge_percentage": 75.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1339.5, "standard_charge_percentage": 100.0000, "estimated_amount": 1339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 669.75, "standard_charge_percentage": 50.0000, "estimated_amount": 669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 946.36, "standard_charge_percentage": 78.5000, "estimated_amount": 946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1019.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 967.39, "standard_charge_percentage": 78.5000, "estimated_amount": 967, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1272.53, "standard_charge_percentage": 95.0000, "estimated_amount": 1272, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 669.75, "standard_charge_percentage": 50.0000, "estimated_amount": 669, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1205.55, "standard_charge_percentage": 90.0000, "estimated_amount": 1205, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1051.51, "standard_charge_percentage": 78.5000, "estimated_amount": 1051, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 530.44, "standard_charge_percentage": 39.6000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 998.93, "standard_charge_percentage": 78.5000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1312.71, "standard_charge_percentage": 98.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 535.8, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1071.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1205.55, "standard_charge_percentage": 90.0000, "estimated_amount": 1205, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 803.7, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1019.96, "standard_charge_percentage": 78.5000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1339.5, "estimated_amount": 1339, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1205.55, "standard_charge_percentage": 90.0000, "estimated_amount": 1205, "methodology": "percent of total billed charges" }]}]} , { "description": "Removal of breast lesion", "code_information": [ { "code": "19120", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19824.1, "discounted_cash": 4472,"minimum": 374.23,"maximum": 19824.1,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17841.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4816.42, "estimated_amount": 4816, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 3405.9, "estimated_amount": 3405, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 5332.47, "estimated_amount": 5332, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15095.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15561.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15561, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9912.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19427.6, "standard_charge_percentage": 98.0000, "estimated_amount": 19427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16850.5, "standard_charge_percentage": 85.0000, "estimated_amount": 16850, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 3268.28, "estimated_amount": 3268, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17841.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17841, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16850.5, "standard_charge_percentage": 85.0000, "estimated_amount": 16850, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17841.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15561.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15561, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7850.34, "standard_charge_percentage": 39.6000, "estimated_amount": 7850, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15095.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15095, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 3509.11, "estimated_amount": 3509, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14005.7, "standard_charge_percentage": 78.5000, "estimated_amount": 14005, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15095.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15095.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15406.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18832.9, "standard_charge_percentage": 95.0000, "estimated_amount": 18832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14783.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5947.23, "standard_charge_percentage": 30.0000, "estimated_amount": 5947, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19824.1, "standard_charge_percentage": 100.0000, "estimated_amount": 19824, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9912.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14317, "standard_charge_percentage": 78.5000, "estimated_amount": 14316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 6880.6, "estimated_amount": 6880, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18832.9, "standard_charge_percentage": 95.0000, "estimated_amount": 18832, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1784.71, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15561.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15561, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9912.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9912, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14868.1, "standard_charge_percentage": 75.0000, "estimated_amount": 14868, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10903.3, "standard_charge_percentage": 55.0000, "estimated_amount": 10903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 5332.47, "estimated_amount": 5332, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15859.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14783.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14783, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15095.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 3474.7, "estimated_amount": 3474, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17346.1, "standard_charge_percentage": 87.5000, "estimated_amount": 17346, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Perq Dev Place Breast Loc 1St Les W Mammo Guid", "code_information": [ { "code": "19281", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2401.57, "discounted_cash": 1892,"minimum": 720.47,"maximum": 2401.57,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1734.41, "standard_charge_percentage": 78.5000, "estimated_amount": 1734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2041.33, "standard_charge_percentage": 85.0000, "estimated_amount": 2041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1047.88, "estimated_amount": 1047, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1200.79, "standard_charge_percentage": 50.0000, "estimated_amount": 1200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2353.54, "standard_charge_percentage": 98.0000, "estimated_amount": 2353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1801.18, "standard_charge_percentage": 75.0000, "estimated_amount": 1801, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2281.49, "standard_charge_percentage": 95.0000, "estimated_amount": 2281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1885.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2281.49, "standard_charge_percentage": 95.0000, "estimated_amount": 2281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2401.57, "standard_charge_percentage": 100.0000, "estimated_amount": 2401, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 720.47, "standard_charge_percentage": 30.0000, "estimated_amount": 720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1885.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1828.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1440.94, "standard_charge_percentage": 60.0000, "estimated_amount": 1440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2161.41, "standard_charge_percentage": 90.0000, "estimated_amount": 2161, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1200.79, "standard_charge_percentage": 50.0000, "estimated_amount": 1200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1696.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1828.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1790.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2401.57, "estimated_amount": 2401, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1200.79, "standard_charge_percentage": 50.0000, "estimated_amount": 1200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1828.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1828, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1921.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1866.38, "standard_charge_percentage": 78.5000, "estimated_amount": 1866, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1885.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1885, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 951.02, "standard_charge_percentage": 39.6000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2161.41, "standard_charge_percentage": 90.0000, "estimated_amount": 2161, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1828.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2161.41, "standard_charge_percentage": 90.0000, "estimated_amount": 2161, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1790.97, "standard_charge_percentage": 78.5000, "estimated_amount": 1790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1828.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2101.37, "standard_charge_percentage": 87.5000, "estimated_amount": 2101, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2041.33, "standard_charge_percentage": 85.0000, "estimated_amount": 2041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1066.3, "standard_charge_percentage": 44.4000, "estimated_amount": 1066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1320.86, "standard_charge_percentage": 55.0000, "estimated_amount": 1320, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Device Placemt Breast Loc Ea Les W Guidnce", "code_information": [ { "code": "19282", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1775,"minimum": 511,"maximum": 1775,"payers_information":[{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1597.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1553.13, "standard_charge_percentage": 87.5000, "estimated_amount": 1553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 788.1, "standard_charge_percentage": 44.4000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1323.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1597.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1775, "standard_charge_percentage": 100.0000, "estimated_amount": 1775, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1351.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1393.38, "standard_charge_percentage": 78.5000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1508.75, "standard_charge_percentage": 85.0000, "estimated_amount": 1508, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 887.5, "standard_charge_percentage": 50.0000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1351.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1686.25, "standard_charge_percentage": 95.0000, "estimated_amount": 1686, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1047.88, "estimated_amount": 1047, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1393.38, "standard_charge_percentage": 78.5000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1281.9, "standard_charge_percentage": 78.5000, "estimated_amount": 1281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1379.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1379, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 887.5, "standard_charge_percentage": 50.0000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1254.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1331.25, "standard_charge_percentage": 75.0000, "estimated_amount": 1331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1393.38, "standard_charge_percentage": 78.5000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 887.5, "standard_charge_percentage": 50.0000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1508.75, "standard_charge_percentage": 85.0000, "estimated_amount": 1508, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1420, "standard_charge_percentage": 80.0000, "estimated_amount": 1420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1323.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1323, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 976.25, "standard_charge_percentage": 55.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 532.5, "standard_charge_percentage": 30.0000, "estimated_amount": 532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1351.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1686.25, "standard_charge_percentage": 95.0000, "estimated_amount": 1686, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 702.9, "standard_charge_percentage": 39.6000, "estimated_amount": 702, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1739.5, "standard_charge_percentage": 98.0000, "estimated_amount": 1739, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1597.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1065, "standard_charge_percentage": 60.0000, "estimated_amount": 1065, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1351.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1351.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1351, "methodology": "percent of total billed charges" }]}]} , { "description": "Perq dev breast 1st strtctc", "code_information": [ { "code": "19283", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2964.05, "discounted_cash": 821,"minimum": 600.5,"maximum": 2964.05,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2094.1, "standard_charge_percentage": 78.5000, "estimated_amount": 2094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2210.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2210, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2519.44, "standard_charge_percentage": 85.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1047.88, "estimated_amount": 1047, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2519.44, "standard_charge_percentage": 85.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1778.43, "standard_charge_percentage": 60.0000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2815.85, "standard_charge_percentage": 95.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 889.22, "standard_charge_percentage": 30.0000, "estimated_amount": 889, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1173.76, "standard_charge_percentage": 39.6000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1482.03, "standard_charge_percentage": 50.0000, "estimated_amount": 1482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2140.64, "standard_charge_percentage": 78.5000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2904.77, "standard_charge_percentage": 98.0000, "estimated_amount": 2904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2815.85, "standard_charge_percentage": 95.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2210.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1316.04, "standard_charge_percentage": 44.4000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2223.04, "standard_charge_percentage": 75.0000, "estimated_amount": 2223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2303.51, "standard_charge_percentage": 78.5000, "estimated_amount": 2303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2593.54, "standard_charge_percentage": 87.5000, "estimated_amount": 2593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2964.05, "standard_charge_percentage": 100.0000, "estimated_amount": 2964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2371.24, "standard_charge_percentage": 80.0000, "estimated_amount": 2371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2667.64, "standard_charge_percentage": 90.0000, "estimated_amount": 2667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2326.78, "standard_charge_percentage": 78.5000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1630.23, "standard_charge_percentage": 55.0000, "estimated_amount": 1630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2256.98, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Breast Loc Dev Place Strotact Guid Add Les", "code_information": [ { "code": "19284", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 707.28,"minimum": 212.18,"maximum": 707.28,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 527.45, "standard_charge_percentage": 78.5000, "estimated_amount": 527, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 424.37, "standard_charge_percentage": 60.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 314.03, "standard_charge_percentage": 44.4000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 549.66, "standard_charge_percentage": 78.5000, "estimated_amount": 549, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 353.64, "standard_charge_percentage": 50.0000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 353.64, "standard_charge_percentage": 50.0000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 601.19, "standard_charge_percentage": 85.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 538.56, "standard_charge_percentage": 78.5000, "estimated_amount": 538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 530.46, "standard_charge_percentage": 75.0000, "estimated_amount": 530, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 636.55, "standard_charge_percentage": 90.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 693.13, "standard_charge_percentage": 98.0000, "estimated_amount": 693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 671.92, "standard_charge_percentage": 95.0000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 389, "standard_charge_percentage": 55.0000, "estimated_amount": 389, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 510.8, "standard_charge_percentage": 78.5000, "estimated_amount": 510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 538.56, "standard_charge_percentage": 78.5000, "estimated_amount": 538, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 636.55, "standard_charge_percentage": 90.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 212.18, "standard_charge_percentage": 30.0000, "estimated_amount": 212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 636.55, "standard_charge_percentage": 90.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 353.64, "standard_charge_percentage": 50.0000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 499.69, "standard_charge_percentage": 78.5000, "estimated_amount": 499, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 707.28, "estimated_amount": 707, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 555.21, "standard_charge_percentage": 78.5000, "estimated_amount": 555, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 538.56, "standard_charge_percentage": 78.5000, "estimated_amount": 538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 707.28, "standard_charge_percentage": 100.0000, "estimated_amount": 707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 618.87, "standard_charge_percentage": 87.5000, "estimated_amount": 618, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 555.21, "standard_charge_percentage": 78.5000, "estimated_amount": 555, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 671.92, "standard_charge_percentage": 95.0000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 527.45, "standard_charge_percentage": 78.5000, "estimated_amount": 527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 538.56, "standard_charge_percentage": 78.5000, "estimated_amount": 538, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 538.56, "standard_charge_percentage": 78.5000, "estimated_amount": 538, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 565.82, "standard_charge_percentage": 80.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 280.08, "standard_charge_percentage": 39.6000, "estimated_amount": 280, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 601.19, "standard_charge_percentage": 85.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 555.21, "standard_charge_percentage": 78.5000, "estimated_amount": 555, "methodology": "percent of total billed charges" }]}]} , { "description": "US XTR NON VAS COMPLETE", "code_information": [ { "code": "19285", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1808, "discounted_cash": 821,"minimum": 542.4,"maximum": 23739.9,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 18076.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 22552.9, "standard_charge_percentage": 95.0000, "estimated_amount": 22552, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 17704, "standard_charge_percentage": 78.5000, "estimated_amount": 17704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1627.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1536.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1536, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1084.8, "standard_charge_percentage": 60.0000, "estimated_amount": 1084, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1405.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1405, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 23265.1, "standard_charge_percentage": 98.0000, "estimated_amount": 23265, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 715.97, "standard_charge_percentage": 39.6000, "estimated_amount": 715, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 802.75, "standard_charge_percentage": 44.4000, "estimated_amount": 802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1356, "standard_charge_percentage": 75.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1376.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1376, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 21365.9, "standard_charge_percentage": 90.0000, "estimated_amount": 21365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 17704, "standard_charge_percentage": 78.5000, "estimated_amount": 17704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 18635.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1277.35, "standard_charge_percentage": 78.5000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1376.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1419.28, "standard_charge_percentage": 78.5000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 13056.9, "standard_charge_percentage": 55.0000, "estimated_amount": 13056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1808, "standard_charge_percentage": 100.0000, "estimated_amount": 1808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 23739.9, "standard_charge_percentage": 100.0000, "estimated_amount": 23739, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1047.88, "estimated_amount": 1047, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 20178.9, "standard_charge_percentage": 85.0000, "estimated_amount": 20178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11870, "standard_charge_percentage": 50.0000, "estimated_amount": 11869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1348.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 904, "standard_charge_percentage": 50.0000, "estimated_amount": 904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 21365.9, "standard_charge_percentage": 90.0000, "estimated_amount": 21365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 904, "standard_charge_percentage": 50.0000, "estimated_amount": 904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1627.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1536.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1536, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1376.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1376, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 904, "standard_charge_percentage": 50.0000, "estimated_amount": 904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 18076.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18076, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 18449.5, "standard_charge_percentage": 78.5000, "estimated_amount": 18449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 18076.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18076, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11870, "standard_charge_percentage": 50.0000, "estimated_amount": 11869, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17804.9, "standard_charge_percentage": 75.0000, "estimated_amount": 17804, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 21365.9, "standard_charge_percentage": 90.0000, "estimated_amount": 21365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 18076.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18076, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1348.32, "standard_charge_percentage": 78.5000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 17145, "standard_charge_percentage": 78.5000, "estimated_amount": 17144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1627.2, "standard_charge_percentage": 90.0000, "estimated_amount": 1627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 542.4, "standard_charge_percentage": 30.0000, "estimated_amount": 542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 18076.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 20178.9, "standard_charge_percentage": 85.0000, "estimated_amount": 20178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1376.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1717.6, "standard_charge_percentage": 95.0000, "estimated_amount": 1717, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1717.6, "standard_charge_percentage": 95.0000, "estimated_amount": 1717, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11870, "standard_charge_percentage": 50.0000, "estimated_amount": 11869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 22552.9, "standard_charge_percentage": 95.0000, "estimated_amount": 22552, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7121.97, "standard_charge_percentage": 30.0000, "estimated_amount": 7121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9401, "standard_charge_percentage": 39.6000, "estimated_amount": 9401, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 18991.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18991, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 18635.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 16772.2, "standard_charge_percentage": 78.5000, "estimated_amount": 16772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1446.4, "standard_charge_percentage": 80.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1582, "standard_charge_percentage": 87.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1419.28, "standard_charge_percentage": 78.5000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1771.84, "standard_charge_percentage": 98.0000, "estimated_amount": 1771, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 18635.8, "standard_charge_percentage": 78.5000, "estimated_amount": 18635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1419.28, "standard_charge_percentage": 78.5000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1376.7, "standard_charge_percentage": 78.5000, "estimated_amount": 1376, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1305.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 994.4, "standard_charge_percentage": 55.0000, "estimated_amount": 994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 20772.4, "standard_charge_percentage": 87.5000, "estimated_amount": 20772, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" }]}]} , { "description": "US XTR NON VASC LMTD", "code_information": [ { "code": "19286", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1457.64,"minimum": 437.29,"maximum": 1457.64,"payers_information":[{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1238.99, "standard_charge_percentage": 85.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 874.58, "standard_charge_percentage": 60.0000, "estimated_amount": 874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1109.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1093.23, "standard_charge_percentage": 75.0000, "estimated_amount": 1093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1029.82, "standard_charge_percentage": 78.5000, "estimated_amount": 1029, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 728.82, "standard_charge_percentage": 50.0000, "estimated_amount": 728, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1275.44, "standard_charge_percentage": 87.5000, "estimated_amount": 1275, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1047.88, "estimated_amount": 1047, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1384.76, "standard_charge_percentage": 95.0000, "estimated_amount": 1384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1109.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1144.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1144, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1311.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1109.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1052.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1052, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1311.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 801.7, "standard_charge_percentage": 55.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 728.82, "standard_charge_percentage": 50.0000, "estimated_amount": 728, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1144.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1457.64, "standard_charge_percentage": 100.0000, "estimated_amount": 1457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1132.8, "standard_charge_percentage": 78.5000, "estimated_amount": 1132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 647.19, "standard_charge_percentage": 44.4000, "estimated_amount": 647, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1428.49, "standard_charge_percentage": 98.0000, "estimated_amount": 1428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1166.11, "standard_charge_percentage": 80.0000, "estimated_amount": 1166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 437.29, "standard_charge_percentage": 30.0000, "estimated_amount": 437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1384.76, "standard_charge_percentage": 95.0000, "estimated_amount": 1384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1087.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1087, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1109.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1311.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1144.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1144, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1238.99, "standard_charge_percentage": 85.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 728.82, "standard_charge_percentage": 50.0000, "estimated_amount": 728, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1109.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 577.23, "standard_charge_percentage": 39.6000, "estimated_amount": 577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1087.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1087, "methodology": "percent of total billed charges" }]}]} , { "description": "Perq dev breast 1st mr guide", "code_information": [ { "code": "19287", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3545, "discounted_cash": 821,"minimum": 600.5,"maximum": 3545,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3190.5, "standard_charge_percentage": 90.0000, "estimated_amount": 3190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2658.75, "standard_charge_percentage": 75.0000, "estimated_amount": 2658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2699.34, "standard_charge_percentage": 78.5000, "estimated_amount": 2699, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2699.34, "standard_charge_percentage": 78.5000, "estimated_amount": 2699, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1264.22, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3545, "standard_charge_percentage": 100.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2782.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2699.34, "standard_charge_percentage": 78.5000, "estimated_amount": 2699, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2127, "standard_charge_percentage": 60.0000, "estimated_amount": 2127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2643.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2643, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3474.1, "standard_charge_percentage": 98.0000, "estimated_amount": 3474, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1047.88, "estimated_amount": 1047, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1949.75, "standard_charge_percentage": 55.0000, "estimated_amount": 1949, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3190.5, "standard_charge_percentage": 90.0000, "estimated_amount": 3190, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1772.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1772, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1403.82, "standard_charge_percentage": 39.6000, "estimated_amount": 1403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1297, "estimated_amount": 1297, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2755, "standard_charge_percentage": 78.5000, "estimated_amount": 2755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2643.68, "standard_charge_percentage": 78.5000, "estimated_amount": 2643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2699.34, "standard_charge_percentage": 78.5000, "estimated_amount": 2699, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 979.77, "estimated_amount": 979, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3101.88, "standard_charge_percentage": 87.5000, "estimated_amount": 3101, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 600.5, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2699.34, "standard_charge_percentage": 78.5000, "estimated_amount": 2699, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3013.25, "standard_charge_percentage": 85.0000, "estimated_amount": 3013, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1772.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1772, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2560.2, "standard_charge_percentage": 78.5000, "estimated_amount": 2560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 884.95, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3013.25, "standard_charge_percentage": 85.0000, "estimated_amount": 3013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1063.5, "standard_charge_percentage": 30.0000, "estimated_amount": 1063, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 644.75, "estimated_amount": 644, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2504.54, "standard_charge_percentage": 78.5000, "estimated_amount": 2504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3367.75, "standard_charge_percentage": 95.0000, "estimated_amount": 3367, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3190.5, "standard_charge_percentage": 90.0000, "estimated_amount": 3190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3367.75, "standard_charge_percentage": 95.0000, "estimated_amount": 3367, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1772.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2782.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2782.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 638.43, "estimated_amount": 638, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2836, "standard_charge_percentage": 80.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 632.11, "estimated_amount": 632, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 625.79, "estimated_amount": 625, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Breast Loc Dev Place Mri Guide Addl Lesion", "code_information": [ { "code": "19288", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2116.92,"minimum": 511,"maximum": 2116.92,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1611.93, "standard_charge_percentage": 78.5000, "estimated_amount": 1611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1058.46, "standard_charge_percentage": 50.0000, "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1611.93, "standard_charge_percentage": 78.5000, "estimated_amount": 1611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2116.92, "standard_charge_percentage": 100.0000, "estimated_amount": 2116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 635.08, "standard_charge_percentage": 30.0000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1058.46, "standard_charge_percentage": 50.0000, "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1905.23, "standard_charge_percentage": 90.0000, "estimated_amount": 1905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1661.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1799.38, "standard_charge_percentage": 85.0000, "estimated_amount": 1799, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1297, "estimated_amount": 1297, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1611.93, "standard_charge_percentage": 78.5000, "estimated_amount": 1611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1905.23, "standard_charge_percentage": 90.0000, "estimated_amount": 1905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1611.93, "standard_charge_percentage": 78.5000, "estimated_amount": 1611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1661.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1661, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 838.3, "standard_charge_percentage": 39.6000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2074.58, "standard_charge_percentage": 98.0000, "estimated_amount": 2074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1578.69, "standard_charge_percentage": 78.5000, "estimated_amount": 1578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2011.07, "standard_charge_percentage": 95.0000, "estimated_amount": 2011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1578.69, "standard_charge_percentage": 78.5000, "estimated_amount": 1578, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2011.07, "standard_charge_percentage": 95.0000, "estimated_amount": 2011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1852.31, "standard_charge_percentage": 87.5000, "estimated_amount": 1852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1645.16, "standard_charge_percentage": 78.5000, "estimated_amount": 1645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1799.38, "standard_charge_percentage": 85.0000, "estimated_amount": 1799, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1047.88, "estimated_amount": 1047, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1693.54, "standard_charge_percentage": 80.0000, "estimated_amount": 1693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1587.69, "standard_charge_percentage": 75.0000, "estimated_amount": 1587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1495.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1164.31, "standard_charge_percentage": 55.0000, "estimated_amount": 1164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1905.23, "standard_charge_percentage": 90.0000, "estimated_amount": 1905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1611.93, "standard_charge_percentage": 78.5000, "estimated_amount": 1611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1270.15, "standard_charge_percentage": 60.0000, "estimated_amount": 1270, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1528.84, "standard_charge_percentage": 78.5000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1661.78, "standard_charge_percentage": 78.5000, "estimated_amount": 1661, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1058.46, "standard_charge_percentage": 50.0000, "estimated_amount": 1058, "methodology": "percent of total billed charges" }]}]} , { "description": "Mastectomy for gynecomastia", "code_information": [ { "code": "19300", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 52571.7, "discounted_cash": 4472,"minimum": 1704,"maximum": 52571.7,"payers_information":[{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 26285.8, "standard_charge_percentage": 50.0000, "estimated_amount": 26285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 52571.7, "standard_charge_percentage": 100.0000, "estimated_amount": 52571, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 20818.4, "standard_charge_percentage": 39.6000, "estimated_amount": 20818, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 46000.2, "standard_charge_percentage": 87.5000, "estimated_amount": 46000, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 41268.8, "standard_charge_percentage": 78.5000, "estimated_amount": 41268, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 3474.7, "estimated_amount": 3474, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 44685.9, "standard_charge_percentage": 85.0000, "estimated_amount": 44685, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 47314.5, "standard_charge_percentage": 90.0000, "estimated_amount": 47314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 39428.8, "standard_charge_percentage": 75.0000, "estimated_amount": 39428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 40030.7, "standard_charge_percentage": 78.5000, "estimated_amount": 40030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 3268.28, "estimated_amount": 3268, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 41268.8, "standard_charge_percentage": 78.5000, "estimated_amount": 41268, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 44685.9, "standard_charge_percentage": 85.0000, "estimated_amount": 44685, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 40030.7, "standard_charge_percentage": 78.5000, "estimated_amount": 40030, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 37967.3, "standard_charge_percentage": 78.5000, "estimated_amount": 37967, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 49943.1, "standard_charge_percentage": 95.0000, "estimated_amount": 49943, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 3405.9, "estimated_amount": 3405, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 5332.47, "estimated_amount": 5332, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 5332.47, "estimated_amount": 5332, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4816.42, "estimated_amount": 4816, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 41268.8, "standard_charge_percentage": 78.5000, "estimated_amount": 41268, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 47314.5, "standard_charge_percentage": 90.0000, "estimated_amount": 47314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 40030.7, "standard_charge_percentage": 78.5000, "estimated_amount": 40030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 39205.3, "standard_charge_percentage": 78.5000, "estimated_amount": 39205, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 26285.8, "standard_charge_percentage": 50.0000, "estimated_amount": 26285, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 40030.7, "standard_charge_percentage": 78.5000, "estimated_amount": 40030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 37141.9, "standard_charge_percentage": 78.5000, "estimated_amount": 37141, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 39205.3, "standard_charge_percentage": 78.5000, "estimated_amount": 39205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 28914.4, "standard_charge_percentage": 55.0000, "estimated_amount": 28914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 6880.6, "estimated_amount": 6880, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 47314.5, "standard_charge_percentage": 90.0000, "estimated_amount": 47314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 15771.5, "standard_charge_percentage": 30.0000, "estimated_amount": 15771, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 4130.63, "estimated_amount": 4130, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 40856.1, "standard_charge_percentage": 78.5000, "estimated_amount": 40856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 3509.11, "estimated_amount": 3509, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 51520.3, "standard_charge_percentage": 98.0000, "estimated_amount": 51520, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 40030.7, "standard_charge_percentage": 78.5000, "estimated_amount": 40030, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 42057.4, "standard_charge_percentage": 80.0000, "estimated_amount": 42057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 26285.8, "standard_charge_percentage": 50.0000, "estimated_amount": 26285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 49943.1, "standard_charge_percentage": 95.0000, "estimated_amount": 49943, "methodology": "percent of total billed charges" }]}]} , { "description": "Partial mastectomy", "code_information": [ { "code": "19301", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 22461.8, "discounted_cash": 4472,"minimum": 374.23,"maximum": 22461.8,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11230.9, "standard_charge_percentage": 50.0000, "estimated_amount": 11230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11230.9, "standard_charge_percentage": 50.0000, "estimated_amount": 11230, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 20215.6, "standard_charge_percentage": 90.0000, "estimated_amount": 20215, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11230.9, "standard_charge_percentage": 50.0000, "estimated_amount": 11230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 15869.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 21338.7, "standard_charge_percentage": 95.0000, "estimated_amount": 21338, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 17103.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 17456.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 22461.8, "standard_charge_percentage": 100.0000, "estimated_amount": 22461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4816.42, "estimated_amount": 4816, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 16750.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21338.7, "standard_charge_percentage": 95.0000, "estimated_amount": 21338, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 17103.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 20215.6, "standard_charge_percentage": 90.0000, "estimated_amount": 20215, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 22012.6, "standard_charge_percentage": 98.0000, "estimated_amount": 22012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 3474.7, "estimated_amount": 3474, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 5332.47, "estimated_amount": 5332, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 17103.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 3509.11, "estimated_amount": 3509, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 16750.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16750, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 4130.63, "estimated_amount": 4130, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 6880.6, "estimated_amount": 6880, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 19092.5, "standard_charge_percentage": 85.0000, "estimated_amount": 19092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8894.87, "standard_charge_percentage": 39.6000, "estimated_amount": 8894, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 5332.47, "estimated_amount": 5332, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 17632.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12354, "standard_charge_percentage": 55.0000, "estimated_amount": 12353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 17103.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6738.54, "standard_charge_percentage": 30.0000, "estimated_amount": 6738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 17103.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17103, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16221.9, "standard_charge_percentage": 78.5000, "estimated_amount": 16221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 17632.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17632, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 19092.5, "standard_charge_percentage": 85.0000, "estimated_amount": 19092, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 20215.6, "standard_charge_percentage": 90.0000, "estimated_amount": 20215, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 19654.1, "standard_charge_percentage": 87.5000, "estimated_amount": 19654, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 16846.3, "standard_charge_percentage": 75.0000, "estimated_amount": 16846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 3268.28, "estimated_amount": 3268, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 3405.9, "estimated_amount": 3405, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 17632.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 17969.4, "standard_charge_percentage": 80.0000, "estimated_amount": 17969, "methodology": "percent of total billed charges" }]}]} , { "description": "P-mastectomy w/ln removal", "code_information": [ { "code": "19302", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 34484.1, "discounted_cash": 7616,"minimum": 728.83,"maximum": 34484.1,"payers_information":[{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 4130.63, "estimated_amount": 4130, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 30173.6, "standard_charge_percentage": 87.5000, "estimated_amount": 30173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 27070, "standard_charge_percentage": 78.5000, "estimated_amount": 27070, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4316, "estimated_amount": 4316, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 27070, "standard_charge_percentage": 78.5000, "estimated_amount": 27070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 26257.9, "standard_charge_percentage": 78.5000, "estimated_amount": 26257, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 31035.7, "standard_charge_percentage": 90.0000, "estimated_amount": 31035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8202.61, "estimated_amount": 8202, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 32759.9, "standard_charge_percentage": 95.0000, "estimated_amount": 32759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 34484.1, "standard_charge_percentage": 100.0000, "estimated_amount": 34484, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 5976.19, "estimated_amount": 5976, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 13655.7, "standard_charge_percentage": 39.6000, "estimated_amount": 13655, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 17242, "standard_charge_percentage": 50.0000, "estimated_amount": 17242, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 5566.06, "estimated_amount": 5566, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 17242, "standard_charge_percentage": 50.0000, "estimated_amount": 17242, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 29311.5, "standard_charge_percentage": 85.0000, "estimated_amount": 29311, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 27070, "standard_charge_percentage": 78.5000, "estimated_amount": 27070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10345.2, "standard_charge_percentage": 30.0000, "estimated_amount": 10345, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 26799.3, "standard_charge_percentage": 78.5000, "estimated_amount": 26799, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 24363, "standard_charge_percentage": 78.5000, "estimated_amount": 24363, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 24904.4, "standard_charge_percentage": 78.5000, "estimated_amount": 24904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 26257.9, "standard_charge_percentage": 78.5000, "estimated_amount": 26257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 31035.7, "standard_charge_percentage": 90.0000, "estimated_amount": 31035, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 32759.9, "standard_charge_percentage": 95.0000, "estimated_amount": 32759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 11718, "estimated_amount": 11718, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 728.83, "estimated_amount": 728, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 33794.4, "standard_charge_percentage": 98.0000, "estimated_amount": 33794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 25716.5, "standard_charge_percentage": 78.5000, "estimated_amount": 25716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 29311.5, "standard_charge_percentage": 85.0000, "estimated_amount": 29311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 25716.5, "standard_charge_percentage": 78.5000, "estimated_amount": 25716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 5917.6, "estimated_amount": 5917, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 25863.1, "standard_charge_percentage": 75.0000, "estimated_amount": 25863, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 26257.9, "standard_charge_percentage": 78.5000, "estimated_amount": 26257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 17242, "standard_charge_percentage": 50.0000, "estimated_amount": 17242, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 728.83, "estimated_amount": 728, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 27587.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 26257.9, "standard_charge_percentage": 78.5000, "estimated_amount": 26257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 31035.7, "standard_charge_percentage": 90.0000, "estimated_amount": 31035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 18966.3, "standard_charge_percentage": 55.0000, "estimated_amount": 18966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 5800.42, "estimated_amount": 5800, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 26257.9, "standard_charge_percentage": 78.5000, "estimated_amount": 26257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" }]}]} , { "description": "Mast simple complete", "code_information": [ { "code": "19303", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38101.6, "discounted_cash": 7616,"minimum": 460.29,"maximum": 38101.6,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 5800.42, "estimated_amount": 5800, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 20955.9, "standard_charge_percentage": 55.0000, "estimated_amount": 20955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 28414.3, "standard_charge_percentage": 78.5000, "estimated_amount": 28414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 34291.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11430.5, "standard_charge_percentage": 30.0000, "estimated_amount": 11430, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 32386.4, "standard_charge_percentage": 85.0000, "estimated_amount": 32386, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 27517, "standard_charge_percentage": 78.5000, "estimated_amount": 27516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 28414.3, "standard_charge_percentage": 78.5000, "estimated_amount": 28414, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 4130.63, "estimated_amount": 4130, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 28576.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28576, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 32386.4, "standard_charge_percentage": 85.0000, "estimated_amount": 32386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 38101.6, "standard_charge_percentage": 100.0000, "estimated_amount": 38101, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 37339.6, "standard_charge_percentage": 98.0000, "estimated_amount": 37339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 11718, "estimated_amount": 11718, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15088.2, "standard_charge_percentage": 39.6000, "estimated_amount": 15088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 5917.6, "estimated_amount": 5917, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 34291.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8202.61, "estimated_amount": 8202, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 26918.8, "standard_charge_percentage": 78.5000, "estimated_amount": 26918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 36196.5, "standard_charge_percentage": 95.0000, "estimated_amount": 36196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 33338.9, "standard_charge_percentage": 87.5000, "estimated_amount": 33338, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 29610.7, "standard_charge_percentage": 78.5000, "estimated_amount": 29610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 5976.19, "estimated_amount": 5976, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 36196.5, "standard_charge_percentage": 95.0000, "estimated_amount": 36196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 5566.06, "estimated_amount": 5566, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 34291.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "19307", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18166, "discounted_cash": 7616,"minimum": 374.23,"maximum": 18166,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 5976.19, "estimated_amount": 5976, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4316, "estimated_amount": 4316, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16349.4, "standard_charge_percentage": 90.0000, "estimated_amount": 16349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13119.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17257.7, "standard_charge_percentage": 95.0000, "estimated_amount": 17257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8202.61, "estimated_amount": 8202, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16349.4, "standard_charge_percentage": 90.0000, "estimated_amount": 16349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17257.7, "standard_charge_percentage": 95.0000, "estimated_amount": 17257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15441.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15441, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 15895.3, "standard_charge_percentage": 87.5000, "estimated_amount": 15895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13547.3, "standard_charge_percentage": 78.5000, "estimated_amount": 13547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 5917.6, "estimated_amount": 5917, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 11718, "estimated_amount": 11718, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5449.81, "standard_charge_percentage": 30.0000, "estimated_amount": 5449, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 17802.7, "standard_charge_percentage": 98.0000, "estimated_amount": 17802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 5800.42, "estimated_amount": 5800, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16349.4, "standard_charge_percentage": 90.0000, "estimated_amount": 16349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18166, "standard_charge_percentage": 100.0000, "estimated_amount": 18166, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9083.02, "standard_charge_percentage": 50.0000, "estimated_amount": 9083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 8687.36, "estimated_amount": 8687, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 12834.3, "standard_charge_percentage": 78.5000, "estimated_amount": 12834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13547.3, "standard_charge_percentage": 78.5000, "estimated_amount": 13547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15441.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 9991.32, "standard_charge_percentage": 55.0000, "estimated_amount": 9991, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9083.02, "standard_charge_percentage": 50.0000, "estimated_amount": 9083, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 13624.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14260.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14260, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14532.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 5566.06, "estimated_amount": 5566, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14117.7, "standard_charge_percentage": 78.5000, "estimated_amount": 14117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7193.75, "standard_charge_percentage": 39.6000, "estimated_amount": 7193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14260.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14260.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14260, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9083.02, "standard_charge_percentage": 50.0000, "estimated_amount": 9083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 13832.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "19330", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 31638.3, "discounted_cash": 4472,"minimum": 243.24,"maximum": 31638.3,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 24836, "standard_charge_percentage": 78.5000, "estimated_amount": 24836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 6880.6, "estimated_amount": 6880, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 24587.7, "standard_charge_percentage": 78.5000, "estimated_amount": 24587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4816.42, "estimated_amount": 4816, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 15819.1, "standard_charge_percentage": 50.0000, "estimated_amount": 15819, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 9491.48, "standard_charge_percentage": 30.0000, "estimated_amount": 9491, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 26892.5, "standard_charge_percentage": 85.0000, "estimated_amount": 26892, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 24836, "standard_charge_percentage": 78.5000, "estimated_amount": 24836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 3268.28, "estimated_amount": 3268, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 31638.3, "standard_charge_percentage": 100.0000, "estimated_amount": 31638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 23728.7, "standard_charge_percentage": 75.0000, "estimated_amount": 23728, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 5332.47, "estimated_amount": 5332, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 15819.1, "standard_charge_percentage": 50.0000, "estimated_amount": 15819, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 15819.1, "standard_charge_percentage": 50.0000, "estimated_amount": 15819, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 26892.5, "standard_charge_percentage": 85.0000, "estimated_amount": 26892, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 24091, "standard_charge_percentage": 78.5000, "estimated_amount": 24090, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 28474.4, "standard_charge_percentage": 90.0000, "estimated_amount": 28474, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 17401, "standard_charge_percentage": 55.0000, "estimated_amount": 17401, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 22849.1, "standard_charge_percentage": 78.5000, "estimated_amount": 22849, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 12528.8, "standard_charge_percentage": 39.6000, "estimated_amount": 12528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 30056.3, "standard_charge_percentage": 95.0000, "estimated_amount": 30056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 27683.5, "standard_charge_percentage": 87.5000, "estimated_amount": 27683, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 5332.47, "estimated_amount": 5332, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 31005.5, "standard_charge_percentage": 98.0000, "estimated_amount": 31005, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 24091, "standard_charge_percentage": 78.5000, "estimated_amount": 24090, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 24091, "standard_charge_percentage": 78.5000, "estimated_amount": 24090, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 24091, "standard_charge_percentage": 78.5000, "estimated_amount": 24090, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 3509.11, "estimated_amount": 3509, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 28474.4, "standard_charge_percentage": 90.0000, "estimated_amount": 28474, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 3405.9, "estimated_amount": 3405, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 28474.4, "standard_charge_percentage": 90.0000, "estimated_amount": 28474, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 3474.7, "estimated_amount": 3474, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 22352.4, "standard_charge_percentage": 78.5000, "estimated_amount": 22352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 23594.2, "standard_charge_percentage": 78.5000, "estimated_amount": 23594, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 24091, "standard_charge_percentage": 78.5000, "estimated_amount": 24090, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 24836, "standard_charge_percentage": 78.5000, "estimated_amount": 24836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 23594.2, "standard_charge_percentage": 78.5000, "estimated_amount": 23594, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 30056.3, "standard_charge_percentage": 95.0000, "estimated_amount": 30056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 25310.6, "standard_charge_percentage": 80.0000, "estimated_amount": 25310, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 3440.3, "estimated_amount": 3440, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 4130.63, "estimated_amount": 4130, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "19380", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 50178.1, "discounted_cash": 7616,"minimum": 460.29,"maximum": 50178.1,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 37633.5, "standard_charge_percentage": 75.0000, "estimated_amount": 37633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 5917.6, "estimated_amount": 5917, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 39389.8, "standard_charge_percentage": 78.5000, "estimated_amount": 39389, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 25089, "standard_charge_percentage": 50.0000, "estimated_amount": 25089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 39389.8, "standard_charge_percentage": 78.5000, "estimated_amount": 39389, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 11718, "estimated_amount": 11718, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 38208.1, "standard_charge_percentage": 78.5000, "estimated_amount": 38208, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 4130.63, "estimated_amount": 4130, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 5976.19, "estimated_amount": 5976, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8202.61, "estimated_amount": 8202, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 37420.3, "standard_charge_percentage": 78.5000, "estimated_amount": 37420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 43905.8, "standard_charge_percentage": 87.5000, "estimated_amount": 43905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 5800.42, "estimated_amount": 5800, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 42651.3, "standard_charge_percentage": 85.0000, "estimated_amount": 42651, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 49174.5, "standard_charge_percentage": 98.0000, "estimated_amount": 49174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 39389.8, "standard_charge_percentage": 78.5000, "estimated_amount": 39389, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 38208.1, "standard_charge_percentage": 78.5000, "estimated_amount": 38208, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4316, "estimated_amount": 4316, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 15053.4, "standard_charge_percentage": 30.0000, "estimated_amount": 15053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 27597.9, "standard_charge_percentage": 55.0000, "estimated_amount": 27597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 38995.9, "standard_charge_percentage": 78.5000, "estimated_amount": 38995, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 19870.5, "standard_charge_percentage": 39.6000, "estimated_amount": 19870, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 38208.1, "standard_charge_percentage": 78.5000, "estimated_amount": 38208, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 38208.1, "standard_charge_percentage": 78.5000, "estimated_amount": 38208, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 45160.3, "standard_charge_percentage": 90.0000, "estimated_amount": 45160, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 45160.3, "standard_charge_percentage": 90.0000, "estimated_amount": 45160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 47669.2, "standard_charge_percentage": 95.0000, "estimated_amount": 47669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 37420.3, "standard_charge_percentage": 78.5000, "estimated_amount": 37420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 5566.06, "estimated_amount": 5566, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 35450.8, "standard_charge_percentage": 78.5000, "estimated_amount": 35450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 25089, "standard_charge_percentage": 50.0000, "estimated_amount": 25089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 42651.3, "standard_charge_percentage": 85.0000, "estimated_amount": 42651, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 45160.3, "standard_charge_percentage": 90.0000, "estimated_amount": 45160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 25089, "standard_charge_percentage": 50.0000, "estimated_amount": 25089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9081.47, "estimated_amount": 9081, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 38208.1, "standard_charge_percentage": 78.5000, "estimated_amount": 38208, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 36238.6, "standard_charge_percentage": 78.5000, "estimated_amount": 36238, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 5859.01, "estimated_amount": 5859, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 50178.1, "standard_charge_percentage": 100.0000, "estimated_amount": 50178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 40142.4, "standard_charge_percentage": 80.0000, "estimated_amount": 40142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 47669.2, "standard_charge_percentage": 95.0000, "estimated_amount": 47669, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Explore Wound Abdomen/Flank/Back", "code_information": [ { "code": "20102", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1963.25, "discounted_cash": 2136,"minimum": 325.58,"maximum": 1963.25,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1865.09, "standard_charge_percentage": 95.0000, "estimated_amount": 1865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1717.84, "standard_charge_percentage": 87.5000, "estimated_amount": 1717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1177.95, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 588.98, "standard_charge_percentage": 30.0000, "estimated_amount": 588, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1963.25, "estimated_amount": 1963, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 981.63, "standard_charge_percentage": 50.0000, "estimated_amount": 981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 785.3, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1417.86, "standard_charge_percentage": 78.5000, "estimated_amount": 1417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1525.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1865.09, "standard_charge_percentage": 95.0000, "estimated_amount": 1865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1766.92, "standard_charge_percentage": 90.0000, "estimated_amount": 1766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1464.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1561.24, "estimated_amount": 1561, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1963.25, "estimated_amount": 1963, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1963.25, "estimated_amount": 1963, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 981.63, "standard_charge_percentage": 50.0000, "estimated_amount": 981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1387.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1541.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1766.92, "standard_charge_percentage": 90.0000, "estimated_amount": 1766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1923.98, "standard_charge_percentage": 98.0000, "estimated_amount": 1923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1963.25, "standard_charge_percentage": 100.0000, "estimated_amount": 1963, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1668.76, "standard_charge_percentage": 85.0000, "estimated_amount": 1668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1766.92, "standard_charge_percentage": 90.0000, "estimated_amount": 1766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1079.79, "standard_charge_percentage": 55.0000, "estimated_amount": 1079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1464.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1659.84, "estimated_amount": 1659, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1472.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1279.63, "estimated_amount": 1279, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1626.98, "estimated_amount": 1626, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1668.76, "standard_charge_percentage": 85.0000, "estimated_amount": 1668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1963.25, "estimated_amount": 1963, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 981.63, "standard_charge_percentage": 50.0000, "estimated_amount": 981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1541.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1541.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1676.28, "estimated_amount": 1676, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 777.45, "standard_charge_percentage": 39.6000, "estimated_amount": 777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1643.41, "estimated_amount": 1643, "methodology": "fee schedule" }]}]} , { "description": "Explore wound extremity", "code_information": [ { "code": "20103", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1963.25, "discounted_cash": 1892,"minimum": 325.58,"maximum": 1963.25,"payers_information":[{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1668.76, "standard_charge_percentage": 85.0000, "estimated_amount": 1668, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 479.56, "estimated_amount": 479, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1963.25, "estimated_amount": 1963, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1079.79, "standard_charge_percentage": 55.0000, "estimated_amount": 1079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1766.92, "standard_charge_percentage": 90.0000, "estimated_amount": 1766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1963.25, "standard_charge_percentage": 100.0000, "estimated_amount": 1963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 981.63, "standard_charge_percentage": 50.0000, "estimated_amount": 981, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1766.92, "standard_charge_percentage": 90.0000, "estimated_amount": 1766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1865.09, "standard_charge_percentage": 95.0000, "estimated_amount": 1865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 1963.25, "estimated_amount": 1963, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1668.76, "standard_charge_percentage": 85.0000, "estimated_amount": 1668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1472.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1472, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1541.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 981.63, "standard_charge_percentage": 50.0000, "estimated_amount": 981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1963.25, "estimated_amount": 1963, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1464.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1464, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1525.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1766.92, "standard_charge_percentage": 90.0000, "estimated_amount": 1766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1541.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1865.09, "standard_charge_percentage": 95.0000, "estimated_amount": 1865, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 777.45, "standard_charge_percentage": 39.6000, "estimated_amount": 777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 1963.25, "estimated_amount": 1963, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1923.98, "standard_charge_percentage": 98.0000, "estimated_amount": 1923, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 981.63, "standard_charge_percentage": 50.0000, "estimated_amount": 981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1387.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1417.86, "standard_charge_percentage": 78.5000, "estimated_amount": 1417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1541.15, "standard_charge_percentage": 78.5000, "estimated_amount": 1541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1177.95, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 785.3, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 785, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1717.84, "standard_charge_percentage": 87.5000, "estimated_amount": 1717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1570.6, "standard_charge_percentage": 80.0000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 588.98, "standard_charge_percentage": 30.0000, "estimated_amount": 588, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1494.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1464.09, "standard_charge_percentage": 78.5000, "estimated_amount": 1464, "methodology": "percent of total billed charges" }]}]} , { "description": "Muscle biopsy superficial", "code_information": [ { "code": "20200", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2774.56, "discounted_cash": 1892,"minimum": 243.24,"maximum": 2774.56,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1960.23, "standard_charge_percentage": 78.5000, "estimated_amount": 1960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1387.28, "standard_charge_percentage": 50.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2358.38, "standard_charge_percentage": 85.0000, "estimated_amount": 2358, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2427.74, "standard_charge_percentage": 87.5000, "estimated_amount": 2427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2497.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2497, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2112.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1387.28, "standard_charge_percentage": 50.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2112.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2112.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2178.03, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1109.82, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2358.38, "standard_charge_percentage": 85.0000, "estimated_amount": 2358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2635.83, "standard_charge_percentage": 95.0000, "estimated_amount": 2635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2112.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2178.03, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2156.25, "standard_charge_percentage": 78.5000, "estimated_amount": 2156, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2069.13, "standard_charge_percentage": 78.5000, "estimated_amount": 2069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2774.56, "standard_charge_percentage": 100.0000, "estimated_amount": 2774, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1387.28, "standard_charge_percentage": 50.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2719.07, "standard_charge_percentage": 98.0000, "estimated_amount": 2719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2497.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1664.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2178.03, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2112.69, "standard_charge_percentage": 78.5000, "estimated_amount": 2112, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2497.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2497, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2003.79, "standard_charge_percentage": 78.5000, "estimated_amount": 2003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2635.83, "standard_charge_percentage": 95.0000, "estimated_amount": 2635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2219.65, "standard_charge_percentage": 80.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1098.73, "standard_charge_percentage": 39.6000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2080.92, "standard_charge_percentage": 75.0000, "estimated_amount": 2080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 832.37, "standard_charge_percentage": 30.0000, "estimated_amount": 832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1526.01, "standard_charge_percentage": 55.0000, "estimated_amount": 1526, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2774.56, "estimated_amount": 2774, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2069.13, "standard_charge_percentage": 78.5000, "estimated_amount": 2069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" }]}]} , { "description": "Hc Deep Muscle Biopsy", "code_information": [ { "code": "20205", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2775.73, "discounted_cash": 3342,"minimum": 325.58,"maximum": 16543.9,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2157.16, "standard_charge_percentage": 78.5000, "estimated_amount": 2157, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1526.65, "standard_charge_percentage": 55.0000, "estimated_amount": 1526, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2775.73, "estimated_amount": 2775, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2775.73, "estimated_amount": 2775, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2428.76, "standard_charge_percentage": 87.5000, "estimated_amount": 2428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 8271.95, "standard_charge_percentage": 50.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2004.63, "standard_charge_percentage": 78.5000, "estimated_amount": 2004, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2720.22, "standard_charge_percentage": 98.0000, "estimated_amount": 2720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 832.72, "standard_charge_percentage": 30.0000, "estimated_amount": 832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 6551.38, "standard_charge_percentage": 39.6000, "estimated_amount": 6551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2178.95, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2113.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2113, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2070, "standard_charge_percentage": 78.5000, "estimated_amount": 2070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 12337.6, "standard_charge_percentage": 78.5000, "estimated_amount": 12337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2636.94, "standard_charge_percentage": 95.0000, "estimated_amount": 2636, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1665.44, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1665, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2113.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2498.16, "standard_charge_percentage": 90.0000, "estimated_amount": 2498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1110.29, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2113.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 12987, "standard_charge_percentage": 78.5000, "estimated_amount": 12986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2113.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1387.87, "standard_charge_percentage": 50.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 15716.7, "standard_charge_percentage": 95.0000, "estimated_amount": 15716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 16213, "standard_charge_percentage": 98.0000, "estimated_amount": 16213, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2359.37, "standard_charge_percentage": 85.0000, "estimated_amount": 2359, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 14889.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14889, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1099.19, "standard_charge_percentage": 39.6000, "estimated_amount": 1099, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 11948, "standard_charge_percentage": 78.5000, "estimated_amount": 11948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2775.73, "estimated_amount": 2775, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 8271.95, "standard_charge_percentage": 50.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2113.58, "standard_charge_percentage": 78.5000, "estimated_amount": 2113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2636.94, "standard_charge_percentage": 95.0000, "estimated_amount": 2636, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 14475.9, "standard_charge_percentage": 87.5000, "estimated_amount": 14475, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1387.87, "standard_charge_percentage": 50.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2498.16, "standard_charge_percentage": 90.0000, "estimated_amount": 2498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2070, "standard_charge_percentage": 78.5000, "estimated_amount": 2070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2775.73, "standard_charge_percentage": 100.0000, "estimated_amount": 2775, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 15716.7, "standard_charge_percentage": 95.0000, "estimated_amount": 15716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 14889.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14889, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4963.17, "standard_charge_percentage": 30.0000, "estimated_amount": 4963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 12337.6, "standard_charge_percentage": 78.5000, "estimated_amount": 12337, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 12987, "standard_charge_percentage": 78.5000, "estimated_amount": 12986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2775.73, "estimated_amount": 2775, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 12407.9, "standard_charge_percentage": 75.0000, "estimated_amount": 12407, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 14062.3, "standard_charge_percentage": 85.0000, "estimated_amount": 14062, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1387.87, "standard_charge_percentage": 50.0000, "estimated_amount": 1387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2178.95, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12987, "standard_charge_percentage": 78.5000, "estimated_amount": 12986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 14062.3, "standard_charge_percentage": 85.0000, "estimated_amount": 14062, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 14889.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14889, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2178.95, "standard_charge_percentage": 78.5000, "estimated_amount": 2178, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2359.37, "standard_charge_percentage": 85.0000, "estimated_amount": 2359, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 16543.9, "standard_charge_percentage": 100.0000, "estimated_amount": 16543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 12857.1, "standard_charge_percentage": 78.5000, "estimated_amount": 12857, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2498.16, "standard_charge_percentage": 90.0000, "estimated_amount": 2498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 9099.15, "standard_charge_percentage": 55.0000, "estimated_amount": 9099, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2081.8, "standard_charge_percentage": 75.0000, "estimated_amount": 2081, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 8271.95, "standard_charge_percentage": 50.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 11688.3, "standard_charge_percentage": 78.5000, "estimated_amount": 11688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1961.05, "standard_charge_percentage": 78.5000, "estimated_amount": 1961, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2220.58, "standard_charge_percentage": 80.0000, "estimated_amount": 2220, "methodology": "percent of total billed charges" }]}]} , { "description": "Biopsy muscle perq needle", "code_information": [ { "code": "20206", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6830.25, "discounted_cash": 1892,"minimum": 243.24,"maximum": 6830.25,"payers_information":[{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5308.13, "standard_charge_percentage": 78.5000, "estimated_amount": 5308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5976.47, "standard_charge_percentage": 87.5000, "estimated_amount": 5976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5122.69, "standard_charge_percentage": 75.0000, "estimated_amount": 5122, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4825.57, "standard_charge_percentage": 78.5000, "estimated_amount": 4825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4932.81, "standard_charge_percentage": 78.5000, "estimated_amount": 4932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6830.25, "standard_charge_percentage": 100.0000, "estimated_amount": 6830, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 805.47, "estimated_amount": 805, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2049.07, "standard_charge_percentage": 30.0000, "estimated_amount": 2049, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2704.78, "standard_charge_percentage": 39.6000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3756.64, "standard_charge_percentage": 55.0000, "estimated_amount": 3756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6693.65, "standard_charge_percentage": 98.0000, "estimated_amount": 6693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2732.1, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2732, "methodology": "percent of total billed charges" }]}]} , { "description": "EPI STEROID INJ CERV/THORA-PC", "code_information": [ { "code": "20220", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6830.25, "discounted_cash": 1892,"minimum": 243.24,"maximum": 6830.25,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5976.47, "standard_charge_percentage": 87.5000, "estimated_amount": 5976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3756.64, "standard_charge_percentage": 55.0000, "estimated_amount": 3756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2049.07, "standard_charge_percentage": 30.0000, "estimated_amount": 2049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5308.13, "standard_charge_percentage": 78.5000, "estimated_amount": 5308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5122.69, "standard_charge_percentage": 75.0000, "estimated_amount": 5122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6693.65, "standard_charge_percentage": 98.0000, "estimated_amount": 6693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 805.47, "estimated_amount": 805, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2704.78, "standard_charge_percentage": 39.6000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4932.81, "standard_charge_percentage": 78.5000, "estimated_amount": 4932, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2732.1, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2732, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4825.57, "standard_charge_percentage": 78.5000, "estimated_amount": 4825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6830.25, "standard_charge_percentage": 100.0000, "estimated_amount": 6830, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" }]}]} , { "description": "Bone biopsy trocarndl deep", "code_information": [ { "code": "20225", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7071.4, "discounted_cash": 1892,"minimum": 325.58,"maximum": 19254.2,"payers_information":[{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5303.55, "standard_charge_percentage": 75.0000, "estimated_amount": 5303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6364.26, "standard_charge_percentage": 90.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6364.26, "standard_charge_percentage": 90.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5384.52, "standard_charge_percentage": 78.5000, "estimated_amount": 5384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6717.83, "standard_charge_percentage": 95.0000, "estimated_amount": 6717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4995.94, "standard_charge_percentage": 78.5000, "estimated_amount": 4995, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5551.05, "standard_charge_percentage": 78.5000, "estimated_amount": 5551, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3535.7, "standard_charge_percentage": 50.0000, "estimated_amount": 3535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6717.83, "standard_charge_percentage": 95.0000, "estimated_amount": 6717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3889.27, "standard_charge_percentage": 55.0000, "estimated_amount": 3889, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5384.52, "standard_charge_percentage": 78.5000, "estimated_amount": 5384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5106.97, "standard_charge_percentage": 78.5000, "estimated_amount": 5106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5384.52, "standard_charge_percentage": 78.5000, "estimated_amount": 5384, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5495.54, "standard_charge_percentage": 78.5000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6187.48, "standard_charge_percentage": 87.5000, "estimated_amount": 6187, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2800.27, "standard_charge_percentage": 39.6000, "estimated_amount": 2800, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2121.42, "standard_charge_percentage": 30.0000, "estimated_amount": 2121, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5551.05, "standard_charge_percentage": 78.5000, "estimated_amount": 5551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5551.05, "standard_charge_percentage": 78.5000, "estimated_amount": 5551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6010.69, "standard_charge_percentage": 85.0000, "estimated_amount": 6010, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3535.7, "standard_charge_percentage": 50.0000, "estimated_amount": 3535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7071.4, "standard_charge_percentage": 100.0000, "estimated_amount": 7071, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6364.26, "standard_charge_percentage": 90.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6010.69, "standard_charge_percentage": 85.0000, "estimated_amount": 6010, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5273.5, "standard_charge_percentage": 78.5000, "estimated_amount": 5273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5273.5, "standard_charge_percentage": 78.5000, "estimated_amount": 5273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5384.52, "standard_charge_percentage": 78.5000, "estimated_amount": 5384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2828.56, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3535.7, "standard_charge_percentage": 50.0000, "estimated_amount": 3535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5384.52, "standard_charge_percentage": 78.5000, "estimated_amount": 5384, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6929.97, "standard_charge_percentage": 98.0000, "estimated_amount": 6929, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5657.12, "standard_charge_percentage": 80.0000, "estimated_amount": 5657, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Bone Biopsy,Excisional Superf", "code_information": [ { "code": "20240", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4715.17, "discounted_cash": 3342,"minimum": 325.58,"maximum": 4715.17,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4479.41, "standard_charge_percentage": 95.0000, "estimated_amount": 4479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3516.34, "standard_charge_percentage": 78.5000, "estimated_amount": 3516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3590.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3590, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4243.65, "standard_charge_percentage": 90.0000, "estimated_amount": 4243, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4620.87, "standard_charge_percentage": 98.0000, "estimated_amount": 4620, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1867.21, "standard_charge_percentage": 39.6000, "estimated_amount": 1867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3590.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4479.41, "standard_charge_percentage": 95.0000, "estimated_amount": 4479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1886.07, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4243.65, "standard_charge_percentage": 90.0000, "estimated_amount": 4243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3701.41, "standard_charge_percentage": 78.5000, "estimated_amount": 3701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2357.59, "standard_charge_percentage": 50.0000, "estimated_amount": 2357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2593.34, "standard_charge_percentage": 55.0000, "estimated_amount": 2593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3536.38, "standard_charge_percentage": 75.0000, "estimated_amount": 3536, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4125.77, "standard_charge_percentage": 87.5000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3405.3, "standard_charge_percentage": 78.5000, "estimated_amount": 3405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3590.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3590.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2357.59, "standard_charge_percentage": 50.0000, "estimated_amount": 2357, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3331.27, "standard_charge_percentage": 78.5000, "estimated_amount": 3331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3701.41, "standard_charge_percentage": 78.5000, "estimated_amount": 3701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3516.34, "standard_charge_percentage": 78.5000, "estimated_amount": 3516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3664.39, "standard_charge_percentage": 78.5000, "estimated_amount": 3664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2829.1, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 4715.17, "estimated_amount": 4715, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3772.14, "standard_charge_percentage": 80.0000, "estimated_amount": 3772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1414.55, "standard_charge_percentage": 30.0000, "estimated_amount": 1414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3590.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4715.17, "standard_charge_percentage": 100.0000, "estimated_amount": 4715, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2357.59, "standard_charge_percentage": 50.0000, "estimated_amount": 2357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3701.41, "standard_charge_percentage": 78.5000, "estimated_amount": 3701, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4243.65, "standard_charge_percentage": 90.0000, "estimated_amount": 4243, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4007.89, "standard_charge_percentage": 85.0000, "estimated_amount": 4007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4007.89, "standard_charge_percentage": 85.0000, "estimated_amount": 4007, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Bone Biopsy,Excisional Deep", "code_information": [ { "code": "20245", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5157.45, "discounted_cash": 3342,"minimum": 374.23,"maximum": 5157.45,"payers_information":[{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3643.74, "standard_charge_percentage": 78.5000, "estimated_amount": 3643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3927.14, "standard_charge_percentage": 78.5000, "estimated_amount": 3927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 5157.45, "standard_charge_percentage": 100.0000, "estimated_amount": 5157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4899.58, "standard_charge_percentage": 95.0000, "estimated_amount": 4899, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4512.77, "standard_charge_percentage": 87.5000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3927.14, "standard_charge_percentage": 78.5000, "estimated_amount": 3927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3927.14, "standard_charge_percentage": 78.5000, "estimated_amount": 3927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4048.6, "standard_charge_percentage": 78.5000, "estimated_amount": 4048, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1547.23, "standard_charge_percentage": 30.0000, "estimated_amount": 1547, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2042.35, "standard_charge_percentage": 39.6000, "estimated_amount": 2042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2836.6, "standard_charge_percentage": 55.0000, "estimated_amount": 2836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3927.14, "standard_charge_percentage": 78.5000, "estimated_amount": 3927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4899.58, "standard_charge_percentage": 95.0000, "estimated_amount": 4899, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4383.83, "standard_charge_percentage": 85.0000, "estimated_amount": 4383, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2578.72, "standard_charge_percentage": 50.0000, "estimated_amount": 2578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4641.7, "standard_charge_percentage": 90.0000, "estimated_amount": 4641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2062.98, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2062, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3094.47, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2578.72, "standard_charge_percentage": 50.0000, "estimated_amount": 2578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4641.7, "standard_charge_percentage": 90.0000, "estimated_amount": 4641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3927.14, "standard_charge_percentage": 78.5000, "estimated_amount": 3927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3846.17, "standard_charge_percentage": 78.5000, "estimated_amount": 3846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2578.72, "standard_charge_percentage": 50.0000, "estimated_amount": 2578, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4048.6, "standard_charge_percentage": 78.5000, "estimated_amount": 4048, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4008.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3868.09, "standard_charge_percentage": 75.0000, "estimated_amount": 3868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4641.7, "standard_charge_percentage": 90.0000, "estimated_amount": 4641, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3724.71, "standard_charge_percentage": 78.5000, "estimated_amount": 3724, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5054.3, "standard_charge_percentage": 98.0000, "estimated_amount": 5054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3846.17, "standard_charge_percentage": 78.5000, "estimated_amount": 3846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4048.6, "standard_charge_percentage": 78.5000, "estimated_amount": 4048, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4125.96, "standard_charge_percentage": 80.0000, "estimated_amount": 4125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4383.83, "standard_charge_percentage": 85.0000, "estimated_amount": 4383, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" }]}]} , { "description": "Hc Remove Fb Musc/Tendon, Simple", "code_information": [ { "code": "20520", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3767.92, "discounted_cash": 1892,"minimum": 243.24,"maximum": 19254.2,"payers_information":[{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3202.73, "standard_charge_percentage": 85.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1883.96, "standard_charge_percentage": 50.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2662.04, "standard_charge_percentage": 78.5000, "estimated_amount": 2662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2957.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2957, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2957.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2957, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3391.13, "standard_charge_percentage": 90.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2721.19, "standard_charge_percentage": 78.5000, "estimated_amount": 2721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3579.52, "standard_charge_percentage": 95.0000, "estimated_amount": 3579, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3692.56, "standard_charge_percentage": 98.0000, "estimated_amount": 3692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3202.73, "standard_charge_percentage": 85.0000, "estimated_amount": 3202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2809.93, "standard_charge_percentage": 78.5000, "estimated_amount": 2809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1507.17, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1492.1, "standard_charge_percentage": 39.6000, "estimated_amount": 1492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2957.82, "standard_charge_percentage": 78.5000, "estimated_amount": 2957, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1883.96, "standard_charge_percentage": 50.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3391.13, "standard_charge_percentage": 90.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3296.93, "standard_charge_percentage": 87.5000, "estimated_amount": 3296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2072.36, "standard_charge_percentage": 55.0000, "estimated_amount": 2072, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2825.94, "standard_charge_percentage": 75.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3767.92, "standard_charge_percentage": 100.0000, "estimated_amount": 3767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2928.24, "standard_charge_percentage": 78.5000, "estimated_amount": 2928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1130.38, "standard_charge_percentage": 30.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3014.34, "standard_charge_percentage": 80.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3391.13, "standard_charge_percentage": 90.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2869.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2809.93, "standard_charge_percentage": 78.5000, "estimated_amount": 2809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3579.52, "standard_charge_percentage": 95.0000, "estimated_amount": 3579, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1883.96, "standard_charge_percentage": 50.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" }]}]} , { "description": "Removal Of Foreign Body", "code_information": [ { "code": "20525", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19254.2, "discounted_cash": 3342,"minimum": 374.23,"maximum": 19254.2,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Inject Carpal Tunnel", "code_information": [ { "code": "20526", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 507.64, "discounted_cash": 344,"minimum": 152.29,"maximum": 507.64,"payers_information":[{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 398.5, "standard_charge_percentage": 78.5000, "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 507.64, "estimated_amount": 507, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 386.54, "standard_charge_percentage": 78.5000, "estimated_amount": 386, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 497.49, "standard_charge_percentage": 98.0000, "estimated_amount": 497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 431.49, "standard_charge_percentage": 85.0000, "estimated_amount": 431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 378.57, "standard_charge_percentage": 78.5000, "estimated_amount": 378, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 366.62, "standard_charge_percentage": 78.5000, "estimated_amount": 366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 203.06, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 203, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 507.64, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 398.5, "standard_charge_percentage": 78.5000, "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 386.54, "standard_charge_percentage": 78.5000, "estimated_amount": 386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 456.88, "standard_charge_percentage": 90.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 253.82, "standard_charge_percentage": 50.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 253.82, "standard_charge_percentage": 50.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 431.49, "standard_charge_percentage": 85.0000, "estimated_amount": 431, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 394.51, "standard_charge_percentage": 78.5000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 386.54, "standard_charge_percentage": 78.5000, "estimated_amount": 386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 482.26, "standard_charge_percentage": 95.0000, "estimated_amount": 482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 279.2, "standard_charge_percentage": 55.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 507.64, "standard_charge_percentage": 100.0000, "estimated_amount": 507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 201.03, "standard_charge_percentage": 39.6000, "estimated_amount": 201, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 386.54, "standard_charge_percentage": 78.5000, "estimated_amount": 386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 456.88, "standard_charge_percentage": 90.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 152.29, "standard_charge_percentage": 30.0000, "estimated_amount": 152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 386.54, "standard_charge_percentage": 78.5000, "estimated_amount": 386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 253.82, "standard_charge_percentage": 50.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 444.19, "standard_charge_percentage": 87.5000, "estimated_amount": 444, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 456.88, "standard_charge_percentage": 90.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 380.73, "standard_charge_percentage": 75.0000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 358.65, "standard_charge_percentage": 78.5000, "estimated_amount": 358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 398.5, "standard_charge_percentage": 78.5000, "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 378.57, "standard_charge_percentage": 78.5000, "estimated_amount": 378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 482.26, "standard_charge_percentage": 95.0000, "estimated_amount": 482, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 304.58, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 406.11, "standard_charge_percentage": 80.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Inject Tendon Sheath/Ligament", "code_information": [ { "code": "20550", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 567.75, "discounted_cash": 344,"minimum": 170.32,"maximum": 567.75,"payers_information":[{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 482.59, "standard_charge_percentage": 85.0000, "estimated_amount": 482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 445.68, "standard_charge_percentage": 78.5000, "estimated_amount": 445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 423.4, "standard_charge_percentage": 78.5000, "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 539.36, "standard_charge_percentage": 95.0000, "estimated_amount": 539, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 283.88, "standard_charge_percentage": 50.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 496.78, "standard_charge_percentage": 87.5000, "estimated_amount": 496, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 340.65, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 482.59, "standard_charge_percentage": 85.0000, "estimated_amount": 482, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 224.83, "standard_charge_percentage": 39.6000, "estimated_amount": 224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 410.03, "standard_charge_percentage": 78.5000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 510.98, "standard_charge_percentage": 90.0000, "estimated_amount": 510, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 425.81, "standard_charge_percentage": 75.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 539.36, "standard_charge_percentage": 95.0000, "estimated_amount": 539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 432.31, "standard_charge_percentage": 78.5000, "estimated_amount": 432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 567.75, "standard_charge_percentage": 100.0000, "estimated_amount": 567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 432.31, "standard_charge_percentage": 78.5000, "estimated_amount": 432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 432.31, "standard_charge_percentage": 78.5000, "estimated_amount": 432, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 556.39, "standard_charge_percentage": 98.0000, "estimated_amount": 556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 283.88, "standard_charge_percentage": 50.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 227.1, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 312.26, "standard_charge_percentage": 55.0000, "estimated_amount": 312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 445.68, "standard_charge_percentage": 78.5000, "estimated_amount": 445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 510.98, "standard_charge_percentage": 90.0000, "estimated_amount": 510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 445.68, "standard_charge_percentage": 78.5000, "estimated_amount": 445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 432.31, "standard_charge_percentage": 78.5000, "estimated_amount": 432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 441.23, "standard_charge_percentage": 78.5000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 423.4, "standard_charge_percentage": 78.5000, "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 510.98, "standard_charge_percentage": 90.0000, "estimated_amount": 510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 170.32, "standard_charge_percentage": 30.0000, "estimated_amount": 170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 432.31, "standard_charge_percentage": 78.5000, "estimated_amount": 432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 283.88, "standard_charge_percentage": 50.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 401.12, "standard_charge_percentage": 78.5000, "estimated_amount": 401, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 454.2, "standard_charge_percentage": 80.0000, "estimated_amount": 454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" }]}]} , { "description": "Hc Inject Tendon Origin/Insert", "code_information": [ { "code": "20551", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 487.88, "discounted_cash": 344,"minimum": 146.36,"maximum": 487.88,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 439.09, "standard_charge_percentage": 90.0000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 487.88, "estimated_amount": 487, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 463.49, "standard_charge_percentage": 95.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 352.35, "standard_charge_percentage": 78.5000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 379.16, "standard_charge_percentage": 78.5000, "estimated_amount": 379, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 478.12, "standard_charge_percentage": 98.0000, "estimated_amount": 478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 382.99, "standard_charge_percentage": 78.5000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 382.99, "standard_charge_percentage": 78.5000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 344.69, "standard_charge_percentage": 78.5000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 292.73, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 292, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 487.88, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 193.2, "standard_charge_percentage": 39.6000, "estimated_amount": 193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 414.7, "standard_charge_percentage": 85.0000, "estimated_amount": 414, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 371.5, "standard_charge_percentage": 78.5000, "estimated_amount": 371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 195.15, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 195, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 414.7, "standard_charge_percentage": 85.0000, "estimated_amount": 414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 371.5, "standard_charge_percentage": 78.5000, "estimated_amount": 371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 463.49, "standard_charge_percentage": 95.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 363.84, "standard_charge_percentage": 78.5000, "estimated_amount": 363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 146.36, "standard_charge_percentage": 30.0000, "estimated_amount": 146, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 371.5, "standard_charge_percentage": 78.5000, "estimated_amount": 371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 439.09, "standard_charge_percentage": 90.0000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 243.94, "standard_charge_percentage": 50.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 382.99, "standard_charge_percentage": 78.5000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 365.91, "standard_charge_percentage": 75.0000, "estimated_amount": 365, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 439.09, "standard_charge_percentage": 90.0000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 390.3, "standard_charge_percentage": 80.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 426.89, "standard_charge_percentage": 87.5000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 268.33, "standard_charge_percentage": 55.0000, "estimated_amount": 268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 243.94, "standard_charge_percentage": 50.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 487.88, "standard_charge_percentage": 100.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 371.5, "standard_charge_percentage": 78.5000, "estimated_amount": 371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 371.5, "standard_charge_percentage": 78.5000, "estimated_amount": 371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 363.84, "standard_charge_percentage": 78.5000, "estimated_amount": 363, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 243.94, "standard_charge_percentage": 50.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" }]}]} , { "description": "Hc Inject Trigger Point1-2 Muscle", "code_information": [ { "code": "20552", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23, "discounted_cash": 344,"minimum": 251.94,"maximum": 16543.9,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 12407.9, "standard_charge_percentage": 75.0000, "estimated_amount": 12407, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4963.17, "standard_charge_percentage": 30.0000, "estimated_amount": 4963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 8271.95, "standard_charge_percentage": 50.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 14889.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14889, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 14062.3, "standard_charge_percentage": 85.0000, "estimated_amount": 14062, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 14889.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14889, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 14062.3, "standard_charge_percentage": 85.0000, "estimated_amount": 14062, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 12857.1, "standard_charge_percentage": 78.5000, "estimated_amount": 12857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 6551.38, "standard_charge_percentage": 39.6000, "estimated_amount": 6551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 12987, "standard_charge_percentage": 78.5000, "estimated_amount": 12986, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 14475.9, "standard_charge_percentage": 87.5000, "estimated_amount": 14475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 12987, "standard_charge_percentage": 78.5000, "estimated_amount": 12986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 11688.3, "standard_charge_percentage": 78.5000, "estimated_amount": 11688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 15716.7, "standard_charge_percentage": 95.0000, "estimated_amount": 15716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 8271.95, "standard_charge_percentage": 50.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 16213, "standard_charge_percentage": 98.0000, "estimated_amount": 16213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 11948, "standard_charge_percentage": 78.5000, "estimated_amount": 11948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 12337.6, "standard_charge_percentage": 78.5000, "estimated_amount": 12337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 8271.95, "standard_charge_percentage": 50.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 15716.7, "standard_charge_percentage": 95.0000, "estimated_amount": 15716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 12597.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12597, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12987, "standard_charge_percentage": 78.5000, "estimated_amount": 12986, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 13235.1, "standard_charge_percentage": 80.0000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 16543.9, "standard_charge_percentage": 100.0000, "estimated_amount": 16543, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 9099.15, "standard_charge_percentage": 55.0000, "estimated_amount": 9099, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 12337.6, "standard_charge_percentage": 78.5000, "estimated_amount": 12337, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 14889.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14889, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Inject Trigger Points, > 3", "code_information": [ { "code": "20553", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 740.25, "discounted_cash": 344,"minimum": 222.07,"maximum": 740.25,"payers_information":[{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 370.13, "standard_charge_percentage": 50.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 552.04, "standard_charge_percentage": 78.5000, "estimated_amount": 552, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 293.14, "standard_charge_percentage": 39.6000, "estimated_amount": 293, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 370.13, "standard_charge_percentage": 50.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 522.99, "standard_charge_percentage": 78.5000, "estimated_amount": 522, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 575.29, "standard_charge_percentage": 78.5000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 555.19, "standard_charge_percentage": 75.0000, "estimated_amount": 555, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 666.23, "standard_charge_percentage": 90.0000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 552.04, "standard_charge_percentage": 78.5000, "estimated_amount": 552, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 666.23, "standard_charge_percentage": 90.0000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 563.66, "standard_charge_percentage": 78.5000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 740.25, "standard_charge_percentage": 100.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 563.66, "standard_charge_percentage": 78.5000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 647.72, "standard_charge_percentage": 87.5000, "estimated_amount": 647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 444.15, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 444, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 222.07, "standard_charge_percentage": 30.0000, "estimated_amount": 222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 581.1, "standard_charge_percentage": 78.5000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 629.21, "standard_charge_percentage": 85.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 581.1, "standard_charge_percentage": 78.5000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 703.24, "standard_charge_percentage": 95.0000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 370.13, "standard_charge_percentage": 50.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 534.61, "standard_charge_percentage": 78.5000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 666.23, "standard_charge_percentage": 90.0000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 563.66, "standard_charge_percentage": 78.5000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 581.1, "standard_charge_percentage": 78.5000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 703.24, "standard_charge_percentage": 95.0000, "estimated_amount": 703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 563.66, "standard_charge_percentage": 78.5000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 725.45, "standard_charge_percentage": 98.0000, "estimated_amount": 725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 563.66, "standard_charge_percentage": 78.5000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 296.1, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 407.14, "standard_charge_percentage": 55.0000, "estimated_amount": 407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 629.21, "standard_charge_percentage": 85.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 592.2, "standard_charge_percentage": 80.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" }]}]} , { "description": "DRAININJECT JOINTBURSA", "code_information": [ { "code": "20600", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23, "discounted_cash": 344,"minimum": 251.94,"maximum": 2036.23,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Drain/Inject Intermediate Joint/Bursa", "code_information": [ { "code": "20605", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2036.23, "discounted_cash": 344,"minimum": 243.24,"maximum": 2036.23,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1438.6, "standard_charge_percentage": 78.5000, "estimated_amount": 1438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1221.74, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1119.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1470.57, "standard_charge_percentage": 78.5000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 814.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1018.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1527.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 806.35, "standard_charge_percentage": 39.6000, "estimated_amount": 806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1995.51, "standard_charge_percentage": 98.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 610.87, "standard_charge_percentage": 30.0000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1781.7, "standard_charge_percentage": 87.5000, "estimated_amount": 1781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1832.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1550.49, "standard_charge_percentage": 78.5000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1934.42, "standard_charge_percentage": 95.0000, "estimated_amount": 1934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2036.23, "standard_charge_percentage": 100.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1518.52, "standard_charge_percentage": 78.5000, "estimated_amount": 1518, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1730.8, "standard_charge_percentage": 85.0000, "estimated_amount": 1730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1582.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1582, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1598.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1628.98, "standard_charge_percentage": 80.0000, "estimated_amount": 1628, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Arthrocentesis Aspir&/Inj Interm Jt/Burs W/Us", "code_information": [ { "code": "20606", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2535.95, "discounted_cash": 808,"minimum": 286.51,"maximum": 2535.95,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2409.15, "standard_charge_percentage": 95.0000, "estimated_amount": 2409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 615.95, "estimated_amount": 615, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2535.95, "standard_charge_percentage": 100.0000, "estimated_amount": 2535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1791.65, "standard_charge_percentage": 78.5000, "estimated_amount": 1791, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2282.35, "standard_charge_percentage": 90.0000, "estimated_amount": 2282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1931, "standard_charge_percentage": 78.5000, "estimated_amount": 1931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1394.77, "standard_charge_percentage": 55.0000, "estimated_amount": 1394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1901.96, "standard_charge_percentage": 75.0000, "estimated_amount": 1901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 1244.34, "estimated_amount": 1244, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2155.56, "standard_charge_percentage": 85.0000, "estimated_amount": 2155, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1990.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1267.97, "standard_charge_percentage": 50.0000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2155.56, "standard_charge_percentage": 85.0000, "estimated_amount": 2155, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1125.96, "standard_charge_percentage": 44.4000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1970.81, "standard_charge_percentage": 78.5000, "estimated_amount": 1970, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2409.15, "standard_charge_percentage": 95.0000, "estimated_amount": 2409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1990.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1990, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2282.35, "standard_charge_percentage": 90.0000, "estimated_amount": 2282, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1831.46, "standard_charge_percentage": 78.5000, "estimated_amount": 1831, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2485.23, "standard_charge_percentage": 98.0000, "estimated_amount": 2485, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 591.06, "estimated_amount": 591, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2282.35, "standard_charge_percentage": 90.0000, "estimated_amount": 2282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 634.61, "estimated_amount": 634, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1521.57, "standard_charge_percentage": 60.0000, "estimated_amount": 1521, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1004.24, "standard_charge_percentage": 39.6000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1891.18, "standard_charge_percentage": 78.5000, "estimated_amount": 1891, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1891.18, "standard_charge_percentage": 78.5000, "estimated_amount": 1891, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 964.36, "estimated_amount": 964, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 628.39, "estimated_amount": 628, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1931, "standard_charge_percentage": 78.5000, "estimated_amount": 1931, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1267.97, "standard_charge_percentage": 50.0000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1267.97, "standard_charge_percentage": 50.0000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2218.96, "standard_charge_percentage": 87.5000, "estimated_amount": 2218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1931, "standard_charge_percentage": 78.5000, "estimated_amount": 1931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2028.76, "standard_charge_percentage": 80.0000, "estimated_amount": 2028, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 628.26, "estimated_amount": 628, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1931, "standard_charge_percentage": 78.5000, "estimated_amount": 1931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 964.36, "estimated_amount": 964, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 871.04, "estimated_amount": 871, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1990.72, "standard_charge_percentage": 78.5000, "estimated_amount": 1990, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 622.17, "estimated_amount": 622, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1931, "standard_charge_percentage": 78.5000, "estimated_amount": 1931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 760.78, "standard_charge_percentage": 30.0000, "estimated_amount": 760, "methodology": "percent of total billed charges" }]}]} , { "description": "Drain/inj joint/bursa w/o us", "code_information": [ { "code": "20610", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19609.3, "discounted_cash": 344,"minimum": 243.24,"maximum": 19609.3,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14931.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17648.4, "standard_charge_percentage": 90.0000, "estimated_amount": 17648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15393.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1507.33, "standard_charge_percentage": 78.5000, "estimated_amount": 1507, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7765.28, "standard_charge_percentage": 39.6000, "estimated_amount": 7765, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5882.79, "standard_charge_percentage": 30.0000, "estimated_amount": 5882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15393.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15393, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1774.07, "standard_charge_percentage": 85.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1982.78, "standard_charge_percentage": 95.0000, "estimated_amount": 1982, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1043.57, "standard_charge_percentage": 50.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10785.1, "standard_charge_percentage": 55.0000, "estimated_amount": 10785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2045.4, "standard_charge_percentage": 98.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1043.57, "standard_charge_percentage": 50.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9804.65, "standard_charge_percentage": 50.0000, "estimated_amount": 9804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13854, "standard_charge_percentage": 78.5000, "estimated_amount": 13853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16667.9, "standard_charge_percentage": 85.0000, "estimated_amount": 16667, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19217.1, "standard_charge_percentage": 98.0000, "estimated_amount": 19217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1556.48, "standard_charge_percentage": 78.5000, "estimated_amount": 1556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17158.1, "standard_charge_percentage": 87.5000, "estimated_amount": 17158, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16667.9, "standard_charge_percentage": 85.0000, "estimated_amount": 16667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14623.6, "standard_charge_percentage": 78.5000, "estimated_amount": 14623, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 834.86, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14707, "standard_charge_percentage": 75.0000, "estimated_amount": 14706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18628.8, "standard_charge_percentage": 95.0000, "estimated_amount": 18628, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1556.48, "standard_charge_percentage": 78.5000, "estimated_amount": 1556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1638.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15393.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1474.56, "standard_charge_percentage": 78.5000, "estimated_amount": 1474, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 826.51, "standard_charge_percentage": 39.6000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1878.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1638.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1878.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1565.36, "standard_charge_percentage": 75.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14931.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 626.14, "standard_charge_percentage": 30.0000, "estimated_amount": 626, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1147.93, "standard_charge_percentage": 55.0000, "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14161.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14161, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1622.02, "standard_charge_percentage": 78.5000, "estimated_amount": 1622, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2087.14, "standard_charge_percentage": 100.0000, "estimated_amount": 2087, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9804.65, "standard_charge_percentage": 50.0000, "estimated_amount": 9804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14931.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1774.07, "standard_charge_percentage": 85.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1878.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14931.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1826.25, "standard_charge_percentage": 87.5000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1982.78, "standard_charge_percentage": 95.0000, "estimated_amount": 1982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15687.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19609.3, "standard_charge_percentage": 100.0000, "estimated_amount": 19609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15239.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1043.57, "standard_charge_percentage": 50.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14623.6, "standard_charge_percentage": 78.5000, "estimated_amount": 14623, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17648.4, "standard_charge_percentage": 90.0000, "estimated_amount": 17648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1589.25, "standard_charge_percentage": 78.5000, "estimated_amount": 1589, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17648.4, "standard_charge_percentage": 90.0000, "estimated_amount": 17648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1638.4, "standard_charge_percentage": 78.5000, "estimated_amount": 1638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1252.28, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14931.5, "standard_charge_percentage": 78.5000, "estimated_amount": 14931, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9804.65, "standard_charge_percentage": 50.0000, "estimated_amount": 9804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1669.71, "standard_charge_percentage": 80.0000, "estimated_amount": 1669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18628.8, "standard_charge_percentage": 95.0000, "estimated_amount": 18628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/Us", "code_information": [ { "code": "20611", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1544, "discounted_cash": 344,"minimum": 251.94,"maximum": 1544,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1544, "standard_charge_percentage": 100.0000, "estimated_amount": 1544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 772, "standard_charge_percentage": 50.0000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1151.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1115.08, "standard_charge_percentage": 78.5000, "estimated_amount": 1115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1175.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1175, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 772, "standard_charge_percentage": 50.0000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1090.84, "standard_charge_percentage": 78.5000, "estimated_amount": 1090, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1158, "standard_charge_percentage": 75.0000, "estimated_amount": 1158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1466.8, "standard_charge_percentage": 95.0000, "estimated_amount": 1466, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1175.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 772, "standard_charge_percentage": 50.0000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1175.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1212.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 849.2, "standard_charge_percentage": 55.0000, "estimated_amount": 849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 1351, "standard_charge_percentage": 87.5000, "estimated_amount": 1351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 617.6, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 617, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 1389.6, "standard_charge_percentage": 90.0000, "estimated_amount": 1389, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1513.12, "standard_charge_percentage": 98.0000, "estimated_amount": 1513, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 628.26, "estimated_amount": 628, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 926.4, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 926, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1175.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1175, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1212.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 1312.4, "standard_charge_percentage": 85.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1175.68, "standard_charge_percentage": 78.5000, "estimated_amount": 1175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1466.8, "standard_charge_percentage": 95.0000, "estimated_amount": 1466, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1199.92, "standard_charge_percentage": 78.5000, "estimated_amount": 1199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1151.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 1389.6, "standard_charge_percentage": 90.0000, "estimated_amount": 1389, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 463.2, "standard_charge_percentage": 30.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1212.04, "standard_charge_percentage": 78.5000, "estimated_amount": 1212, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 611.42, "standard_charge_percentage": 39.6000, "estimated_amount": 611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 1389.6, "standard_charge_percentage": 90.0000, "estimated_amount": 1389, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 1312.4, "standard_charge_percentage": 85.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 1235.2, "standard_charge_percentage": 80.0000, "estimated_amount": 1235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" }]}]} , { "description": "Aspirate/inj ganglion cyst", "code_information": [ { "code": "20612", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19254.2, "discounted_cash": 344,"minimum": 181.46,"maximum": 19254.2,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 302.43, "standard_charge_percentage": 50.0000, "estimated_amount": 302, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 460.57, "standard_charge_percentage": 78.5000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 302.43, "standard_charge_percentage": 50.0000, "estimated_amount": 302, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 514.13, "standard_charge_percentage": 85.0000, "estimated_amount": 514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5776.26, "standard_charge_percentage": 30.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 470.07, "standard_charge_percentage": 78.5000, "estimated_amount": 470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 453.64, "standard_charge_percentage": 75.0000, "estimated_amount": 453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 474.82, "standard_charge_percentage": 78.5000, "estimated_amount": 474, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 544.37, "standard_charge_percentage": 90.0000, "estimated_amount": 544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18291.5, "standard_charge_percentage": 95.0000, "estimated_amount": 18291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 460.57, "standard_charge_percentage": 78.5000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 544.37, "standard_charge_percentage": 90.0000, "estimated_amount": 544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14963.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14963, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 239.52, "standard_charge_percentage": 39.6000, "estimated_amount": 239, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7624.66, "standard_charge_percentage": 39.6000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 436.83, "standard_charge_percentage": 78.5000, "estimated_amount": 436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 427.33, "standard_charge_percentage": 78.5000, "estimated_amount": 427, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 460.57, "standard_charge_percentage": 78.5000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 474.82, "standard_charge_percentage": 78.5000, "estimated_amount": 474, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 332.67, "standard_charge_percentage": 55.0000, "estimated_amount": 332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 302.43, "standard_charge_percentage": 50.0000, "estimated_amount": 302, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 529.25, "standard_charge_percentage": 87.5000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 474.82, "standard_charge_percentage": 78.5000, "estimated_amount": 474, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 460.57, "standard_charge_percentage": 78.5000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 530.4, "estimated_amount": 530, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 460.57, "standard_charge_percentage": 78.5000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15114.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15114, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 544.37, "standard_charge_percentage": 90.0000, "estimated_amount": 544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 604.86, "standard_charge_percentage": 100.0000, "estimated_amount": 604, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13603.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13603, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14440.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 514.13, "standard_charge_percentage": 85.0000, "estimated_amount": 514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 267.85, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 451.07, "standard_charge_percentage": 78.5000, "estimated_amount": 451, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10589.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10589, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18869.1, "standard_charge_percentage": 98.0000, "estimated_amount": 18869, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 574.62, "standard_charge_percentage": 95.0000, "estimated_amount": 574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 362.92, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 181.46, "standard_charge_percentage": 30.0000, "estimated_amount": 181, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14358.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14358, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 241.94, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13905.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13905, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 306.83, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 262.55, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 270.5, "estimated_amount": 270, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19254.2, "standard_charge_percentage": 100.0000, "estimated_amount": 19254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17328.8, "standard_charge_percentage": 90.0000, "estimated_amount": 17328, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 371.28, "estimated_amount": 371, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 574.62, "standard_charge_percentage": 95.0000, "estimated_amount": 574, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14661.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 411.06, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9627.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16847.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 483.89, "standard_charge_percentage": 80.0000, "estimated_amount": 483, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 592.76, "standard_charge_percentage": 98.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 451.07, "standard_charge_percentage": 78.5000, "estimated_amount": 451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 251.94, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16366.1, "standard_charge_percentage": 85.0000, "estimated_amount": 16366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 265.2, "estimated_amount": 265, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply/Remove Cranial Fix Dev", "code_information": [ { "code": "20660", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5714.24, "discounted_cash": 1869,"minimum": 325.58,"maximum": 5714.24,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1714.27, "standard_charge_percentage": 30.0000, "estimated_amount": 1714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4351.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3142.83, "standard_charge_percentage": 55.0000, "estimated_amount": 3142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1452.22, "estimated_amount": 1452, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4126.82, "standard_charge_percentage": 78.5000, "estimated_amount": 4126, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2012.98, "estimated_amount": 2012, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4261.39, "standard_charge_percentage": 78.5000, "estimated_amount": 4261, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2857.12, "standard_charge_percentage": 50.0000, "estimated_amount": 2857, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4999.96, "standard_charge_percentage": 87.5000, "estimated_amount": 4999, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4485.68, "standard_charge_percentage": 78.5000, "estimated_amount": 4485, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5142.82, "standard_charge_percentage": 90.0000, "estimated_amount": 5142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1466.6, "estimated_amount": 1466, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4351.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4351.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4037.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4037, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4440.82, "standard_charge_percentage": 78.5000, "estimated_amount": 4440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3428.54, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4485.68, "standard_charge_percentage": 78.5000, "estimated_amount": 4485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5142.82, "standard_charge_percentage": 90.0000, "estimated_amount": 5142, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4857.1, "standard_charge_percentage": 85.0000, "estimated_amount": 4857, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2857.12, "standard_charge_percentage": 50.0000, "estimated_amount": 2857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4857.1, "standard_charge_percentage": 85.0000, "estimated_amount": 4857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4261.39, "standard_charge_percentage": 78.5000, "estimated_amount": 4261, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5599.96, "standard_charge_percentage": 98.0000, "estimated_amount": 5599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4485.68, "standard_charge_percentage": 78.5000, "estimated_amount": 4485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 5714.24, "standard_charge_percentage": 100.0000, "estimated_amount": 5714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5428.53, "standard_charge_percentage": 95.0000, "estimated_amount": 5428, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4571.39, "standard_charge_percentage": 80.0000, "estimated_amount": 4571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4351.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4351, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3070.5, "estimated_amount": 3070, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2228.65, "estimated_amount": 2228, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5428.53, "standard_charge_percentage": 95.0000, "estimated_amount": 5428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2875.68, "estimated_amount": 2875, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2857.12, "standard_charge_percentage": 50.0000, "estimated_amount": 2857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4351.11, "standard_charge_percentage": 78.5000, "estimated_amount": 4351, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2262.84, "standard_charge_percentage": 39.6000, "estimated_amount": 2262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5142.82, "standard_charge_percentage": 90.0000, "estimated_amount": 5142, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2285.7, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1365.95, "estimated_amount": 1365, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1423.46, "estimated_amount": 1423, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4285.68, "standard_charge_percentage": 75.0000, "estimated_amount": 4285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2228.65, "estimated_amount": 2228, "methodology": "fee schedule" }]}]} , { "description": "Removal of implant deep", "code_information": [ { "code": "20680", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 26438.6, "discounted_cash": 3342,"minimum": 374.23,"maximum": 26438.6,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 20131.7, "standard_charge_percentage": 78.5000, "estimated_amount": 20131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 22472.8, "standard_charge_percentage": 85.0000, "estimated_amount": 22472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7931.58, "standard_charge_percentage": 30.0000, "estimated_amount": 7931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 25116.7, "standard_charge_percentage": 95.0000, "estimated_amount": 25116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 20754.3, "standard_charge_percentage": 78.5000, "estimated_amount": 20754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 14541.2, "standard_charge_percentage": 55.0000, "estimated_amount": 14541, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 19716.6, "standard_charge_percentage": 78.5000, "estimated_amount": 19716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 10469.7, "standard_charge_percentage": 39.6000, "estimated_amount": 10469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 22472.8, "standard_charge_percentage": 85.0000, "estimated_amount": 22472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 20546.8, "standard_charge_percentage": 78.5000, "estimated_amount": 20546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 25116.7, "standard_charge_percentage": 95.0000, "estimated_amount": 25116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 19829, "standard_charge_percentage": 75.0000, "estimated_amount": 19828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 26438.6, "standard_charge_percentage": 100.0000, "estimated_amount": 26438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 23133.8, "standard_charge_percentage": 87.5000, "estimated_amount": 23133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 20131.7, "standard_charge_percentage": 78.5000, "estimated_amount": 20131, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 13219.3, "standard_charge_percentage": 50.0000, "estimated_amount": 13219, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3070.5, "estimated_amount": 3070, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 20131.7, "standard_charge_percentage": 78.5000, "estimated_amount": 20131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 19716.6, "standard_charge_percentage": 78.5000, "estimated_amount": 19716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 19094, "standard_charge_percentage": 78.5000, "estimated_amount": 19093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 23794.7, "standard_charge_percentage": 90.0000, "estimated_amount": 23794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 20131.7, "standard_charge_percentage": 78.5000, "estimated_amount": 20131, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 13219.3, "standard_charge_percentage": 50.0000, "estimated_amount": 13219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 18678.9, "standard_charge_percentage": 78.5000, "estimated_amount": 18678, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 20131.7, "standard_charge_percentage": 78.5000, "estimated_amount": 20131, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 13219.3, "standard_charge_percentage": 50.0000, "estimated_amount": 13219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 20754.3, "standard_charge_percentage": 78.5000, "estimated_amount": 20754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 25909.8, "standard_charge_percentage": 98.0000, "estimated_amount": 25909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 20754.3, "standard_charge_percentage": 78.5000, "estimated_amount": 20754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 21150.9, "standard_charge_percentage": 80.0000, "estimated_amount": 21150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 23794.7, "standard_charge_percentage": 90.0000, "estimated_amount": 23794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 23794.7, "standard_charge_percentage": 90.0000, "estimated_amount": 23794, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20692", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 13676.3, "discounted_cash": 15027,"minimum": 374.23,"maximum": 13676.3,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 13676.3, "estimated_amount": 13676, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4102.88, "standard_charge_percentage": 30.0000, "estimated_amount": 4102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 10257.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10257, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 10199.1, "standard_charge_percentage": 78.5000, "estimated_amount": 10199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 11624.8, "standard_charge_percentage": 85.0000, "estimated_amount": 11624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 12308.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12308, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 13676.3, "estimated_amount": 13676, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 10735.9, "standard_charge_percentage": 78.5000, "estimated_amount": 10735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 10628.5, "standard_charge_percentage": 78.5000, "estimated_amount": 10628, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 6838.13, "standard_charge_percentage": 50.0000, "estimated_amount": 6838, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 13676.3, "standard_charge_percentage": 100.0000, "estimated_amount": 13676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 11966.7, "standard_charge_percentage": 87.5000, "estimated_amount": 11966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 13676.3, "estimated_amount": 13676, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 12308.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 11675.4, "estimated_amount": 11675, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 7521.94, "standard_charge_percentage": 55.0000, "estimated_amount": 7521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 9662.27, "standard_charge_percentage": 78.5000, "estimated_amount": 9662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 12992.4, "standard_charge_percentage": 95.0000, "estimated_amount": 12992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 11624.8, "standard_charge_percentage": 85.0000, "estimated_amount": 11624, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 10199.1, "standard_charge_percentage": 78.5000, "estimated_amount": 10199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 12992.4, "standard_charge_percentage": 95.0000, "estimated_amount": 12992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 10413.8, "standard_charge_percentage": 78.5000, "estimated_amount": 10413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 10735.9, "standard_charge_percentage": 78.5000, "estimated_amount": 10735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 10413.8, "standard_charge_percentage": 78.5000, "estimated_amount": 10413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 10735.9, "standard_charge_percentage": 78.5000, "estimated_amount": 10735, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 10413.8, "standard_charge_percentage": 78.5000, "estimated_amount": 10413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 6838.13, "standard_charge_percentage": 50.0000, "estimated_amount": 6838, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 9876.99, "standard_charge_percentage": 78.5000, "estimated_amount": 9876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 6838.13, "standard_charge_percentage": 50.0000, "estimated_amount": 6838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 13676.3, "estimated_amount": 13676, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 13402.7, "standard_charge_percentage": 98.0000, "estimated_amount": 13402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 10981.8, "estimated_amount": 10981, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 10413.8, "standard_charge_percentage": 78.5000, "estimated_amount": 10413, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 12308.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 11559.8, "estimated_amount": 11559, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 10413.8, "standard_charge_percentage": 78.5000, "estimated_amount": 10413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 11444.2, "estimated_amount": 11444, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 11791, "estimated_amount": 11791, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3070.5, "estimated_amount": 3070, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 5415.8, "standard_charge_percentage": 39.6000, "estimated_amount": 5415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 10941, "standard_charge_percentage": 80.0000, "estimated_amount": 10941, "methodology": "percent of total billed charges" }]}]} , { "description": "ADJMTREVJ EXT FIXJ SYS ANES", "code_information": [ { "code": "20693", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 16148.2, "discounted_cash": 8343,"minimum": 243.24,"maximum": 16148.2,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 14129.7, "standard_charge_percentage": 87.5000, "estimated_amount": 14129, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 12549.6, "standard_charge_percentage": 78.5000, "estimated_amount": 12549, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 8074.11, "standard_charge_percentage": 50.0000, "estimated_amount": 8074, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 6394.7, "standard_charge_percentage": 39.6000, "estimated_amount": 6394, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 12676.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 12296.1, "standard_charge_percentage": 78.5000, "estimated_amount": 12296, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 13726, "standard_charge_percentage": 85.0000, "estimated_amount": 13725, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3070.5, "estimated_amount": 3070, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 13726, "standard_charge_percentage": 85.0000, "estimated_amount": 13725, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 15825.3, "standard_charge_percentage": 98.0000, "estimated_amount": 15825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 12676.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 12296.1, "standard_charge_percentage": 78.5000, "estimated_amount": 12296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 8074.11, "standard_charge_percentage": 50.0000, "estimated_amount": 8074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 14533.4, "standard_charge_percentage": 90.0000, "estimated_amount": 14533, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 12836.1, "estimated_amount": 12836, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 6097.16, "estimated_amount": 6097, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 11662.2, "standard_charge_percentage": 78.5000, "estimated_amount": 11662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 16148.2, "standard_charge_percentage": 100.0000, "estimated_amount": 16148, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12676.4, "standard_charge_percentage": 78.5000, "estimated_amount": 12676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 12296.1, "standard_charge_percentage": 78.5000, "estimated_amount": 12296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 12111.2, "standard_charge_percentage": 75.0000, "estimated_amount": 12111, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 11408.7, "standard_charge_percentage": 78.5000, "estimated_amount": 11408, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 6353.88, "estimated_amount": 6353, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 12042.5, "standard_charge_percentage": 78.5000, "estimated_amount": 12042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 6482.24, "estimated_amount": 6482, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 14533.4, "standard_charge_percentage": 90.0000, "estimated_amount": 14533, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 6546.42, "estimated_amount": 6546, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 14533.4, "standard_charge_percentage": 90.0000, "estimated_amount": 14533, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 12042.5, "standard_charge_percentage": 78.5000, "estimated_amount": 12042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 8881.52, "standard_charge_percentage": 55.0000, "estimated_amount": 8881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 15340.8, "standard_charge_percentage": 95.0000, "estimated_amount": 15340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 12296.1, "standard_charge_percentage": 78.5000, "estimated_amount": 12296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 15340.8, "standard_charge_percentage": 95.0000, "estimated_amount": 15340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 12296.1, "standard_charge_percentage": 78.5000, "estimated_amount": 12296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4844.47, "standard_charge_percentage": 30.0000, "estimated_amount": 4844, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8985.28, "estimated_amount": 8985, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 8074.11, "standard_charge_percentage": 50.0000, "estimated_amount": 8074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 12918.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12918, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20694", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 32289, "discounted_cash": 1869,"minimum": 243.24,"maximum": 32289,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 16144.5, "standard_charge_percentage": 50.0000, "estimated_amount": 16144, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 31643.2, "standard_charge_percentage": 98.0000, "estimated_amount": 31643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2875.68, "estimated_amount": 2875, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 29060.1, "standard_charge_percentage": 90.0000, "estimated_amount": 29060, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 29060.1, "standard_charge_percentage": 90.0000, "estimated_amount": 29060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 27445.6, "standard_charge_percentage": 85.0000, "estimated_amount": 27445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 24586.4, "standard_charge_percentage": 78.5000, "estimated_amount": 24586, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 12786.4, "standard_charge_percentage": 39.6000, "estimated_amount": 12786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 24586.4, "standard_charge_percentage": 78.5000, "estimated_amount": 24586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2228.65, "estimated_amount": 2228, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1423.46, "estimated_amount": 1423, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 30674.5, "standard_charge_percentage": 95.0000, "estimated_amount": 30674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2228.65, "estimated_amount": 2228, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 32289, "standard_charge_percentage": 100.0000, "estimated_amount": 32288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2012.98, "estimated_amount": 2012, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1466.6, "estimated_amount": 1466, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 24079.5, "standard_charge_percentage": 78.5000, "estimated_amount": 24079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 24586.4, "standard_charge_percentage": 78.5000, "estimated_amount": 24586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 25093.4, "standard_charge_percentage": 78.5000, "estimated_amount": 25093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 9686.69, "standard_charge_percentage": 30.0000, "estimated_amount": 9686, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 24586.4, "standard_charge_percentage": 78.5000, "estimated_amount": 24586, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 23319.1, "standard_charge_percentage": 78.5000, "estimated_amount": 23319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 25346.8, "standard_charge_percentage": 78.5000, "estimated_amount": 25346, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 25346.8, "standard_charge_percentage": 78.5000, "estimated_amount": 25346, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 28252.8, "standard_charge_percentage": 87.5000, "estimated_amount": 28252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 24586.4, "standard_charge_percentage": 78.5000, "estimated_amount": 24586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 24216.7, "standard_charge_percentage": 75.0000, "estimated_amount": 24216, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 27445.6, "standard_charge_percentage": 85.0000, "estimated_amount": 27445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 16144.5, "standard_charge_percentage": 50.0000, "estimated_amount": 16144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 29060.1, "standard_charge_percentage": 90.0000, "estimated_amount": 29060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 16144.5, "standard_charge_percentage": 50.0000, "estimated_amount": 16144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 25831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 25831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 30674.5, "standard_charge_percentage": 95.0000, "estimated_amount": 30674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 24079.5, "standard_charge_percentage": 78.5000, "estimated_amount": 24079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 25346.8, "standard_charge_percentage": 78.5000, "estimated_amount": 25346, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1437.84, "estimated_amount": 1437, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 22812.2, "standard_charge_percentage": 78.5000, "estimated_amount": 22812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 17758.9, "standard_charge_percentage": 55.0000, "estimated_amount": 17758, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1452.22, "estimated_amount": 1452, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1365.95, "estimated_amount": 1365, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3070.5, "estimated_amount": 3070, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20704", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 24573.1,"minimum": 411.63,"maximum": 24573.1,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 18429.8, "standard_charge_percentage": 75.0000, "estimated_amount": 18429, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 21501.4, "standard_charge_percentage": 87.5000, "estimated_amount": 21501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 23344.4, "standard_charge_percentage": 95.0000, "estimated_amount": 23344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 22115.8, "standard_charge_percentage": 90.0000, "estimated_amount": 22115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 24573.1, "standard_charge_percentage": 100.0000, "estimated_amount": 24573, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 20887.1, "standard_charge_percentage": 85.0000, "estimated_amount": 20887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 20887.1, "standard_charge_percentage": 85.0000, "estimated_amount": 20887, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9730.94, "standard_charge_percentage": 39.6000, "estimated_amount": 9730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 23344.4, "standard_charge_percentage": 95.0000, "estimated_amount": 23344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 12286.5, "standard_charge_percentage": 50.0000, "estimated_amount": 12286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 13515.2, "standard_charge_percentage": 55.0000, "estimated_amount": 13515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 18325.4, "standard_charge_percentage": 78.5000, "estimated_amount": 18325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 19097, "standard_charge_percentage": 78.5000, "estimated_amount": 19096, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 19289.9, "standard_charge_percentage": 78.5000, "estimated_amount": 19289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 411.63, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 17746.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17746, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 19289.9, "standard_charge_percentage": 78.5000, "estimated_amount": 19289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 17360.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 19289.9, "standard_charge_percentage": 78.5000, "estimated_amount": 19289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 22115.8, "standard_charge_percentage": 90.0000, "estimated_amount": 22115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 22115.8, "standard_charge_percentage": 90.0000, "estimated_amount": 22115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7371.92, "standard_charge_percentage": 30.0000, "estimated_amount": 7371, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 12286.5, "standard_charge_percentage": 50.0000, "estimated_amount": 12286, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 12286.5, "standard_charge_percentage": 50.0000, "estimated_amount": 12286, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 24081.6, "standard_charge_percentage": 98.0000, "estimated_amount": 24081, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 18711.2, "standard_charge_percentage": 78.5000, "estimated_amount": 18711, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 19658.5, "standard_charge_percentage": 80.0000, "estimated_amount": 19658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 18325.4, "standard_charge_percentage": 78.5000, "estimated_amount": 18325, "methodology": "percent of total billed charges" }]}]} , { "description": "REMOVE CARTILAGE FOR GRAFT", "code_information": [ { "code": "20912", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18250.1, "discounted_cash": 4275,"minimum": 374.23,"maximum": 18250.1,"payers_information":[{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 13896.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13896, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2498, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 13896.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 3354.86, "estimated_amount": 3354, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9125.07, "standard_charge_percentage": 50.0000, "estimated_amount": 9125, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14326.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 12893.7, "standard_charge_percentage": 78.5000, "estimated_amount": 12893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17337.6, "standard_charge_percentage": 95.0000, "estimated_amount": 17337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15512.6, "standard_charge_percentage": 85.0000, "estimated_amount": 15512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18250.1, "standard_charge_percentage": 100.0000, "estimated_amount": 18250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17337.6, "standard_charge_percentage": 95.0000, "estimated_amount": 17337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5475.04, "standard_charge_percentage": 30.0000, "estimated_amount": 5475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 3321.97, "estimated_amount": 3321, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10037.6, "standard_charge_percentage": 55.0000, "estimated_amount": 10037, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16425.1, "standard_charge_percentage": 90.0000, "estimated_amount": 16425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 13687.6, "standard_charge_percentage": 75.0000, "estimated_amount": 13687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 13896.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13896, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13610, "standard_charge_percentage": 78.5000, "estimated_amount": 13610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14326.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14326, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9125.07, "standard_charge_percentage": 50.0000, "estimated_amount": 9125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14183.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16425.1, "standard_charge_percentage": 90.0000, "estimated_amount": 16425, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 13896.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14326.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16425.1, "standard_charge_percentage": 90.0000, "estimated_amount": 16425, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7227.06, "standard_charge_percentage": 39.6000, "estimated_amount": 7227, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9125.07, "standard_charge_percentage": 50.0000, "estimated_amount": 9125, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 17885.1, "standard_charge_percentage": 98.0000, "estimated_amount": 17885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 15968.9, "standard_charge_percentage": 87.5000, "estimated_amount": 15968, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 13896.6, "standard_charge_percentage": 78.5000, "estimated_amount": 13896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3289.08, "estimated_amount": 3289, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13610, "standard_charge_percentage": 78.5000, "estimated_amount": 13610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 3256.19, "estimated_amount": 3256, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4604.71, "estimated_amount": 4604, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15512.6, "standard_charge_percentage": 85.0000, "estimated_amount": 15512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 6578.16, "estimated_amount": 6578, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 3124.63, "estimated_amount": 3124, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13180.3, "standard_charge_percentage": 78.5000, "estimated_amount": 13180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 5098.07, "estimated_amount": 5098, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14600.1, "standard_charge_percentage": 80.0000, "estimated_amount": 14600, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 5098.07, "estimated_amount": 5098, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20930", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 29307.7,"minimum": 511,"maximum": 29307.7,"payers_information":[{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 21980.8, "standard_charge_percentage": 75.0000, "estimated_amount": 21980, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 14653.9, "standard_charge_percentage": 50.0000, "estimated_amount": 14653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 22316.4, "standard_charge_percentage": 78.5000, "estimated_amount": 22316, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 21166, "standard_charge_percentage": 78.5000, "estimated_amount": 21166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 11605.9, "standard_charge_percentage": 39.6000, "estimated_amount": 11605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 22316.4, "standard_charge_percentage": 78.5000, "estimated_amount": 22316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 16119.3, "standard_charge_percentage": 55.0000, "estimated_amount": 16119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 23006.6, "standard_charge_percentage": 78.5000, "estimated_amount": 23006, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 28721.6, "standard_charge_percentage": 98.0000, "estimated_amount": 28721, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 27842.3, "standard_charge_percentage": 95.0000, "estimated_amount": 27842, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 24911.6, "standard_charge_percentage": 85.0000, "estimated_amount": 24911, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 25644.3, "standard_charge_percentage": 87.5000, "estimated_amount": 25644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 14653.9, "standard_charge_percentage": 50.0000, "estimated_amount": 14653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 22316.4, "standard_charge_percentage": 78.5000, "estimated_amount": 22316, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 22316.4, "standard_charge_percentage": 78.5000, "estimated_amount": 22316, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 26377, "standard_charge_percentage": 90.0000, "estimated_amount": 26376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 23006.6, "standard_charge_percentage": 78.5000, "estimated_amount": 23006, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 22316.4, "standard_charge_percentage": 78.5000, "estimated_amount": 22316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 23006.6, "standard_charge_percentage": 78.5000, "estimated_amount": 23006, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 20705.9, "standard_charge_percentage": 78.5000, "estimated_amount": 20705, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 14653.9, "standard_charge_percentage": 50.0000, "estimated_amount": 14653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 21856.3, "standard_charge_percentage": 78.5000, "estimated_amount": 21856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 26377, "standard_charge_percentage": 90.0000, "estimated_amount": 26376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 8792.32, "standard_charge_percentage": 30.0000, "estimated_amount": 8792, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 29307.7, "standard_charge_percentage": 100.0000, "estimated_amount": 29307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 13076.9, "estimated_amount": 13076, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 21856.3, "standard_charge_percentage": 78.5000, "estimated_amount": 21856, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 24911.6, "standard_charge_percentage": 85.0000, "estimated_amount": 24911, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 26377, "standard_charge_percentage": 90.0000, "estimated_amount": 26376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 27842.3, "standard_charge_percentage": 95.0000, "estimated_amount": 27842, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 22776.5, "standard_charge_percentage": 78.5000, "estimated_amount": 22776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 23446.2, "standard_charge_percentage": 80.0000, "estimated_amount": 23446, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20931", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 37223,"minimum": 511,"maximum": 37223,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 29220, "standard_charge_percentage": 78.5000, "estimated_amount": 29220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 27759, "standard_charge_percentage": 78.5000, "estimated_amount": 27759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 35361.8, "standard_charge_percentage": 95.0000, "estimated_amount": 35361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 18611.5, "standard_charge_percentage": 50.0000, "estimated_amount": 18611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 18611.5, "standard_charge_percentage": 50.0000, "estimated_amount": 18611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 27759, "standard_charge_percentage": 78.5000, "estimated_amount": 27759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 35361.8, "standard_charge_percentage": 95.0000, "estimated_amount": 35361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 33500.7, "standard_charge_percentage": 90.0000, "estimated_amount": 33500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 29220, "standard_charge_percentage": 78.5000, "estimated_amount": 29220, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 14740.3, "standard_charge_percentage": 39.6000, "estimated_amount": 14740, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 33500.7, "standard_charge_percentage": 90.0000, "estimated_amount": 33500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 31639.5, "standard_charge_percentage": 85.0000, "estimated_amount": 31639, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 28343.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 28927.8, "standard_charge_percentage": 78.5000, "estimated_amount": 28927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 32570.1, "standard_charge_percentage": 87.5000, "estimated_amount": 32570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 26298, "standard_charge_percentage": 78.5000, "estimated_amount": 26298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 28343.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28343, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 26882.4, "standard_charge_percentage": 78.5000, "estimated_amount": 26882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 27917.2, "standard_charge_percentage": 75.0000, "estimated_amount": 27917, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11166.9, "standard_charge_percentage": 30.0000, "estimated_amount": 11166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 28343.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28343, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 13076.9, "estimated_amount": 13076, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 18611.5, "standard_charge_percentage": 50.0000, "estimated_amount": 18611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 29220, "standard_charge_percentage": 78.5000, "estimated_amount": 29220, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 33500.7, "standard_charge_percentage": 90.0000, "estimated_amount": 33500, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 31639.5, "standard_charge_percentage": 85.0000, "estimated_amount": 31639, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 36478.5, "standard_charge_percentage": 98.0000, "estimated_amount": 36478, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 28343.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 28343.4, "standard_charge_percentage": 78.5000, "estimated_amount": 28343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 29778.4, "standard_charge_percentage": 80.0000, "estimated_amount": 29778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 37223, "standard_charge_percentage": 100.0000, "estimated_amount": 37222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 20472.6, "standard_charge_percentage": 55.0000, "estimated_amount": 20472, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20936", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18734.2,"minimum": 216.49,"maximum": 18734.2,"payers_information":[{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14706.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16860.8, "standard_charge_percentage": 90.0000, "estimated_amount": 16860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18734.2, "standard_charge_percentage": 100.0000, "estimated_amount": 18734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9367.11, "standard_charge_percentage": 50.0000, "estimated_amount": 9367, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17797.5, "standard_charge_percentage": 95.0000, "estimated_amount": 17797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14265.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14559.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 216.49, "estimated_amount": 216, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13971, "standard_charge_percentage": 78.5000, "estimated_amount": 13971, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7418.75, "standard_charge_percentage": 39.6000, "estimated_amount": 7418, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14265.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14050.7, "standard_charge_percentage": 75.0000, "estimated_amount": 14050, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16860.8, "standard_charge_percentage": 90.0000, "estimated_amount": 16860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9367.11, "standard_charge_percentage": 50.0000, "estimated_amount": 9367, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13529.9, "standard_charge_percentage": 78.5000, "estimated_amount": 13529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14706.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14265.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14265, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15924.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15924, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10303.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10303, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 13076.9, "estimated_amount": 13076, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13971, "standard_charge_percentage": 78.5000, "estimated_amount": 13971, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16392.4, "standard_charge_percentage": 87.5000, "estimated_amount": 16392, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9367.11, "standard_charge_percentage": 50.0000, "estimated_amount": 9367, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14265.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 216.49, "estimated_amount": 216, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15924.1, "standard_charge_percentage": 85.0000, "estimated_amount": 15924, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17797.5, "standard_charge_percentage": 95.0000, "estimated_amount": 17797, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18359.5, "standard_charge_percentage": 98.0000, "estimated_amount": 18359, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16860.8, "standard_charge_percentage": 90.0000, "estimated_amount": 16860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13235.7, "standard_charge_percentage": 78.5000, "estimated_amount": 13235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14265.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14706.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14706, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5620.27, "standard_charge_percentage": 30.0000, "estimated_amount": 5620, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14987.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14987, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20937", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8838.13,"minimum": 2651.44,"maximum": 8838.13,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6628.6, "standard_charge_percentage": 75.0000, "estimated_amount": 6628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 7954.32, "standard_charge_percentage": 90.0000, "estimated_amount": 7954, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6729.79, "standard_charge_percentage": 78.5000, "estimated_amount": 6729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 6937.93, "standard_charge_percentage": 78.5000, "estimated_amount": 6937, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 8396.22, "standard_charge_percentage": 95.0000, "estimated_amount": 8396, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4419.06, "standard_charge_percentage": 50.0000, "estimated_amount": 4419, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 8838.13, "estimated_amount": 8838, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6244.14, "standard_charge_percentage": 78.5000, "estimated_amount": 6244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6729.79, "standard_charge_percentage": 78.5000, "estimated_amount": 6729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7512.41, "standard_charge_percentage": 85.0000, "estimated_amount": 7512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6729.79, "standard_charge_percentage": 78.5000, "estimated_amount": 6729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3499.9, "standard_charge_percentage": 39.6000, "estimated_amount": 3499, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6937.93, "standard_charge_percentage": 78.5000, "estimated_amount": 6937, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4419.06, "standard_charge_percentage": 50.0000, "estimated_amount": 4419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3535.25, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 6937.93, "standard_charge_percentage": 78.5000, "estimated_amount": 6937, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 7733.36, "standard_charge_percentage": 87.5000, "estimated_amount": 7733, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4419.06, "standard_charge_percentage": 50.0000, "estimated_amount": 4419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4860.97, "standard_charge_percentage": 55.0000, "estimated_amount": 4860, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6382.9, "standard_charge_percentage": 78.5000, "estimated_amount": 6382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6591.04, "standard_charge_percentage": 78.5000, "estimated_amount": 6591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 8838.13, "standard_charge_percentage": 100.0000, "estimated_amount": 8838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2651.44, "standard_charge_percentage": 30.0000, "estimated_amount": 2651, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 8661.37, "standard_charge_percentage": 98.0000, "estimated_amount": 8661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7512.41, "standard_charge_percentage": 85.0000, "estimated_amount": 7512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 7954.32, "standard_charge_percentage": 90.0000, "estimated_amount": 7954, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 7954.32, "standard_charge_percentage": 90.0000, "estimated_amount": 7954, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6729.79, "standard_charge_percentage": 78.5000, "estimated_amount": 6729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 6868.55, "standard_charge_percentage": 78.5000, "estimated_amount": 6868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7070.5, "standard_charge_percentage": 80.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6729.79, "standard_charge_percentage": 78.5000, "estimated_amount": 6729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 8396.22, "standard_charge_percentage": 95.0000, "estimated_amount": 8396, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6591.04, "standard_charge_percentage": 78.5000, "estimated_amount": 6591, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20985", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 29693.2,"minimum": 511,"maximum": 29693.2,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 22609.9, "standard_charge_percentage": 78.5000, "estimated_amount": 22609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 28208.5, "standard_charge_percentage": 95.0000, "estimated_amount": 28208, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 25239.2, "standard_charge_percentage": 85.0000, "estimated_amount": 25239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 23076.1, "standard_charge_percentage": 78.5000, "estimated_amount": 23076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 29693.2, "standard_charge_percentage": 100.0000, "estimated_amount": 29693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 21444.4, "standard_charge_percentage": 78.5000, "estimated_amount": 21444, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 26723.9, "standard_charge_percentage": 90.0000, "estimated_amount": 26723, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 22269.9, "standard_charge_percentage": 75.0000, "estimated_amount": 22269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 26723.9, "standard_charge_percentage": 90.0000, "estimated_amount": 26723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 23309.2, "standard_charge_percentage": 78.5000, "estimated_amount": 23309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 22143.7, "standard_charge_percentage": 78.5000, "estimated_amount": 22143, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 22609.9, "standard_charge_percentage": 78.5000, "estimated_amount": 22609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 28208.5, "standard_charge_percentage": 95.0000, "estimated_amount": 28208, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 8907.96, "standard_charge_percentage": 30.0000, "estimated_amount": 8907, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 25239.2, "standard_charge_percentage": 85.0000, "estimated_amount": 25239, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 14846.6, "standard_charge_percentage": 50.0000, "estimated_amount": 14846, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 14846.6, "standard_charge_percentage": 50.0000, "estimated_amount": 14846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 22143.7, "standard_charge_percentage": 78.5000, "estimated_amount": 22143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 23309.2, "standard_charge_percentage": 78.5000, "estimated_amount": 23309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 20978.3, "standard_charge_percentage": 78.5000, "estimated_amount": 20978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 25981.5, "standard_charge_percentage": 87.5000, "estimated_amount": 25981, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 22609.9, "standard_charge_percentage": 78.5000, "estimated_amount": 22609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 22609.9, "standard_charge_percentage": 78.5000, "estimated_amount": 22609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 16331.3, "standard_charge_percentage": 55.0000, "estimated_amount": 16331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 14846.6, "standard_charge_percentage": 50.0000, "estimated_amount": 14846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 22609.9, "standard_charge_percentage": 78.5000, "estimated_amount": 22609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 26723.9, "standard_charge_percentage": 90.0000, "estimated_amount": 26723, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 29099.3, "standard_charge_percentage": 98.0000, "estimated_amount": 29099, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 23309.2, "standard_charge_percentage": 78.5000, "estimated_amount": 23309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 23754.6, "standard_charge_percentage": 80.0000, "estimated_amount": 23754, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 11758.5, "standard_charge_percentage": 39.6000, "estimated_amount": 11758, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "21011", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19735.5, "discounted_cash": 1892,"minimum": 243.24,"maximum": 19735.5,"payers_information":[{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16775.2, "standard_charge_percentage": 85.0000, "estimated_amount": 16775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18748.7, "standard_charge_percentage": 95.0000, "estimated_amount": 18748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19735.5, "standard_charge_percentage": 100.0000, "estimated_amount": 19735, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13943.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13943, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15337.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15337, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16775.2, "standard_charge_percentage": 85.0000, "estimated_amount": 16775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5920.65, "standard_charge_percentage": 30.0000, "estimated_amount": 5920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17268.6, "standard_charge_percentage": 87.5000, "estimated_amount": 17268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14801.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19340.8, "standard_charge_percentage": 98.0000, "estimated_amount": 19340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18748.7, "standard_charge_percentage": 95.0000, "estimated_amount": 18748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10854.5, "standard_charge_percentage": 55.0000, "estimated_amount": 10854, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14253, "standard_charge_percentage": 78.5000, "estimated_amount": 14252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7815.26, "standard_charge_percentage": 39.6000, "estimated_amount": 7815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14717.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14717.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" }]}]} , { "description": "Exc face tum deep 2 cm/>", "code_information": [ { "code": "21014", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 22188.4, "discounted_cash": 3342,"minimum": 325.58,"maximum": 22188.4,"payers_information":[{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 18860.1, "standard_charge_percentage": 85.0000, "estimated_amount": 18860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 15676.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 22188.4, "standard_charge_percentage": 100.0000, "estimated_amount": 22188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 21079, "standard_charge_percentage": 95.0000, "estimated_amount": 21078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 21744.6, "standard_charge_percentage": 98.0000, "estimated_amount": 21744, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 16547, "standard_charge_percentage": 78.5000, "estimated_amount": 16547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 19414.8, "standard_charge_percentage": 87.5000, "estimated_amount": 19414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 17243.7, "standard_charge_percentage": 78.5000, "estimated_amount": 17243, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11094.2, "standard_charge_percentage": 50.0000, "estimated_amount": 11094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12203.6, "standard_charge_percentage": 55.0000, "estimated_amount": 12203, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 16547, "standard_charge_percentage": 78.5000, "estimated_amount": 16547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16024.5, "standard_charge_percentage": 78.5000, "estimated_amount": 16024, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 17750.7, "standard_charge_percentage": 80.0000, "estimated_amount": 17750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 16895.4, "standard_charge_percentage": 78.5000, "estimated_amount": 16895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6656.52, "standard_charge_percentage": 30.0000, "estimated_amount": 6656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 18860.1, "standard_charge_percentage": 85.0000, "estimated_amount": 18860, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 16641.3, "standard_charge_percentage": 75.0000, "estimated_amount": 16641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21079, "standard_charge_percentage": 95.0000, "estimated_amount": 21078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 17417.9, "standard_charge_percentage": 78.5000, "estimated_amount": 17417, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 19969.6, "standard_charge_percentage": 90.0000, "estimated_amount": 19969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 8786.61, "standard_charge_percentage": 39.6000, "estimated_amount": 8786, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "21235", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 22831.2, "discounted_cash": 6909,"minimum": 728.83,"maximum": 22831.2,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 20548, "standard_charge_percentage": 90.0000, "estimated_amount": 20548, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 5261.59, "estimated_amount": 5261, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17123.4, "standard_charge_percentage": 75.0000, "estimated_amount": 17123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 17922.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 19406.5, "standard_charge_percentage": 85.0000, "estimated_amount": 19406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 5367.89, "estimated_amount": 5367, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 17026.3, "standard_charge_percentage": 78.5000, "estimated_amount": 17026, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 17384.8, "standard_charge_percentage": 78.5000, "estimated_amount": 17384, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 16488.7, "standard_charge_percentage": 78.5000, "estimated_amount": 16488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 16130.2, "standard_charge_percentage": 78.5000, "estimated_amount": 16130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 8237.85, "estimated_amount": 8237, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 19977.3, "standard_charge_percentage": 87.5000, "estimated_amount": 19977, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 11415.6, "standard_charge_percentage": 50.0000, "estimated_amount": 11415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 4449.79, "estimated_amount": 4449, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 5049, "estimated_amount": 5049, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 17743.2, "standard_charge_percentage": 78.5000, "estimated_amount": 17743, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 9041.14, "standard_charge_percentage": 39.6000, "estimated_amount": 9041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11415.6, "standard_charge_percentage": 50.0000, "estimated_amount": 11415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 8237.85, "estimated_amount": 8237, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 20548, "standard_charge_percentage": 90.0000, "estimated_amount": 20548, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 17384.8, "standard_charge_percentage": 78.5000, "estimated_amount": 17384, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21689.6, "standard_charge_percentage": 95.0000, "estimated_amount": 21689, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 17384.8, "standard_charge_percentage": 78.5000, "estimated_amount": 17384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 17384.8, "standard_charge_percentage": 78.5000, "estimated_amount": 17384, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 21689.6, "standard_charge_percentage": 95.0000, "estimated_amount": 21689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 17026.3, "standard_charge_percentage": 78.5000, "estimated_amount": 17026, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 7440.64, "estimated_amount": 7440, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 728.83, "estimated_amount": 728, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6849.35, "standard_charge_percentage": 30.0000, "estimated_amount": 6849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18264.9, "standard_charge_percentage": 80.0000, "estimated_amount": 18264, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 22374.5, "standard_charge_percentage": 98.0000, "estimated_amount": 22374, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 20548, "standard_charge_percentage": 90.0000, "estimated_amount": 20548, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 5421.03, "estimated_amount": 5421, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 17922.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 10629.5, "estimated_amount": 10629, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 11415.6, "standard_charge_percentage": 50.0000, "estimated_amount": 11415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 12557.1, "standard_charge_percentage": 55.0000, "estimated_amount": 12557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 17922.5, "standard_charge_percentage": 78.5000, "estimated_amount": 17922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 17384.8, "standard_charge_percentage": 78.5000, "estimated_amount": 17384, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 728.83, "estimated_amount": 728, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 19406.5, "standard_charge_percentage": 85.0000, "estimated_amount": 19406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 22831.2, "standard_charge_percentage": 100.0000, "estimated_amount": 22831, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Nose Xf Wo Stabil", "code_information": [ { "code": "21315", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2529, "discounted_cash": 1730,"minimum": 243.24,"maximum": 2529,"payers_information":[{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1786.74, "standard_charge_percentage": 78.5000, "estimated_amount": 1786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1264.27, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 1965.41, "standard_charge_percentage": 78.5000, "estimated_amount": 1965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2402.55, "standard_charge_percentage": 95.0000, "estimated_amount": 2402, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2276.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 1886, "standard_charge_percentage": 78.5000, "estimated_amount": 1886, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1863.13, "estimated_amount": 1863, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1001.48, "standard_charge_percentage": 39.6000, "estimated_amount": 1001, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2402.55, "standard_charge_percentage": 95.0000, "estimated_amount": 2402, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1264.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 1925.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1925, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2212.88, "standard_charge_percentage": 87.5000, "estimated_amount": 2212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2149.65, "standard_charge_percentage": 85.0000, "estimated_amount": 2149, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 1925.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 1925.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 758.7, "standard_charge_percentage": 30.0000, "estimated_amount": 758, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1344.12, "estimated_amount": 1344, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1264.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1171.85, "estimated_amount": 1171, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2276.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1390.95, "standard_charge_percentage": 55.0000, "estimated_amount": 1390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 1896.75, "standard_charge_percentage": 75.0000, "estimated_amount": 1896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1264.5, "standard_charge_percentage": 50.0000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1317.5, "estimated_amount": 1317, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1517.4, "standard_charge_percentage": 60.0000, "estimated_amount": 1517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1122.88, "standard_charge_percentage": 44.4000, "estimated_amount": 1122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2529, "estimated_amount": 2529, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1357.43, "estimated_amount": 1357, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2023.2, "standard_charge_percentage": 80.0000, "estimated_amount": 2023, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 1985.27, "standard_charge_percentage": 78.5000, "estimated_amount": 1985, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2478.42, "standard_charge_percentage": 98.0000, "estimated_amount": 2478, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 1826.44, "standard_charge_percentage": 78.5000, "estimated_amount": 1826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2149.65, "standard_charge_percentage": 85.0000, "estimated_amount": 2149, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1985.27, "standard_charge_percentage": 78.5000, "estimated_amount": 1985, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2276.1, "standard_charge_percentage": 90.0000, "estimated_amount": 2276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 1985.27, "standard_charge_percentage": 78.5000, "estimated_amount": 1985, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 1925.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1925, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 1925.71, "standard_charge_percentage": 78.5000, "estimated_amount": 1925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 1886, "standard_charge_percentage": 78.5000, "estimated_amount": 1886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2529, "standard_charge_percentage": 100.0000, "estimated_amount": 2529, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Nose Fx W Stabil", "code_information": [ { "code": "21320", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3139.76, "discounted_cash": 3787,"minimum": 325.58,"maximum": 3139.76,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1569.88, "standard_charge_percentage": 50.0000, "estimated_amount": 1569, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2884.49, "estimated_amount": 2884, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2390.77, "standard_charge_percentage": 78.5000, "estimated_amount": 2390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3139.76, "standard_charge_percentage": 100.0000, "estimated_amount": 3139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2971.9, "estimated_amount": 2971, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3139.76, "estimated_amount": 3139, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2825.78, "standard_charge_percentage": 90.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2982.77, "standard_charge_percentage": 95.0000, "estimated_amount": 2982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2942.77, "estimated_amount": 2942, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2767.95, "estimated_amount": 2767, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2668.8, "standard_charge_percentage": 85.0000, "estimated_amount": 2668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2668.8, "standard_charge_percentage": 85.0000, "estimated_amount": 2668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1726.87, "standard_charge_percentage": 55.0000, "estimated_amount": 1726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2390.77, "standard_charge_percentage": 78.5000, "estimated_amount": 2390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2440.06, "standard_charge_percentage": 78.5000, "estimated_amount": 2440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2825.78, "standard_charge_percentage": 90.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3076.96, "standard_charge_percentage": 98.0000, "estimated_amount": 3076, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2464.71, "standard_charge_percentage": 78.5000, "estimated_amount": 2464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2390.77, "standard_charge_percentage": 78.5000, "estimated_amount": 2390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2218.24, "standard_charge_percentage": 78.5000, "estimated_amount": 2218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3139.76, "estimated_amount": 3139, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 941.93, "standard_charge_percentage": 30.0000, "estimated_amount": 941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1394.05, "standard_charge_percentage": 44.4000, "estimated_amount": 1394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2341.48, "standard_charge_percentage": 78.5000, "estimated_amount": 2341, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2390.77, "standard_charge_percentage": 78.5000, "estimated_amount": 2390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3139.76, "estimated_amount": 3139, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2341.48, "standard_charge_percentage": 78.5000, "estimated_amount": 2341, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2390.77, "standard_charge_percentage": 78.5000, "estimated_amount": 2390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2354.82, "standard_charge_percentage": 75.0000, "estimated_amount": 2354, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2825.78, "standard_charge_percentage": 90.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1171.85, "estimated_amount": 1171, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3139.76, "estimated_amount": 3139, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2464.71, "standard_charge_percentage": 78.5000, "estimated_amount": 2464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2982.77, "standard_charge_percentage": 95.0000, "estimated_amount": 2982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1569.88, "standard_charge_percentage": 50.0000, "estimated_amount": 1569, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1569.88, "standard_charge_percentage": 50.0000, "estimated_amount": 1569, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2267.53, "standard_charge_percentage": 78.5000, "estimated_amount": 2267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2511.81, "standard_charge_percentage": 80.0000, "estimated_amount": 2511, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2464.71, "standard_charge_percentage": 78.5000, "estimated_amount": 2464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1883.86, "standard_charge_percentage": 60.0000, "estimated_amount": 1883, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1243.34, "standard_charge_percentage": 39.6000, "estimated_amount": 1243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2747.29, "standard_charge_percentage": 87.5000, "estimated_amount": 2747, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" }]}]} , { "description": "Open Tx Nose Fx W/Skele Fixj", "code_information": [ { "code": "21330", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38101.6, "discounted_cash": 6909,"minimum": 374.23,"maximum": 38101.6,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 34291.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 28414.3, "standard_charge_percentage": 78.5000, "estimated_amount": 28414, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 15088.2, "standard_charge_percentage": 39.6000, "estimated_amount": 15088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 5049, "estimated_amount": 5049, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 37339.6, "standard_charge_percentage": 98.0000, "estimated_amount": 37339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 5421.03, "estimated_amount": 5421, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 32386.4, "standard_charge_percentage": 85.0000, "estimated_amount": 32386, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 27517, "standard_charge_percentage": 78.5000, "estimated_amount": 27516, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 34291.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 5261.59, "estimated_amount": 5261, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 36196.5, "standard_charge_percentage": 95.0000, "estimated_amount": 36196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11430.5, "standard_charge_percentage": 30.0000, "estimated_amount": 11430, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 5367.89, "estimated_amount": 5367, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 10629.5, "estimated_amount": 10629, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 8237.85, "estimated_amount": 8237, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 26918.8, "standard_charge_percentage": 78.5000, "estimated_amount": 26918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 36196.5, "standard_charge_percentage": 95.0000, "estimated_amount": 36196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 29610.7, "standard_charge_percentage": 78.5000, "estimated_amount": 29610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3819.73, "estimated_amount": 3819, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 38101.6, "standard_charge_percentage": 100.0000, "estimated_amount": 38101, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 34291.4, "standard_charge_percentage": 90.0000, "estimated_amount": 34291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 33338.9, "standard_charge_percentage": 87.5000, "estimated_amount": 33338, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 8237.85, "estimated_amount": 8237, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 20955.9, "standard_charge_percentage": 55.0000, "estimated_amount": 20955, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 28414.3, "standard_charge_percentage": 78.5000, "estimated_amount": 28414, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 19050.8, "standard_charge_percentage": 50.0000, "estimated_amount": 19050, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 7440.64, "estimated_amount": 7440, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 32386.4, "standard_charge_percentage": 85.0000, "estimated_amount": 32386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 29909.8, "standard_charge_percentage": 78.5000, "estimated_amount": 29909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 30481.3, "standard_charge_percentage": 80.0000, "estimated_amount": 30481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 28576.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28576, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 29012.5, "standard_charge_percentage": 78.5000, "estimated_amount": 29012, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "21336", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 11415.6, "discounted_cash": 3789,"minimum": 460.29,"maximum": 11415.6,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 10844.8, "standard_charge_percentage": 95.0000, "estimated_amount": 10844, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 8561.68, "standard_charge_percentage": 75.0000, "estimated_amount": 8561, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 6278.57, "standard_charge_percentage": 55.0000, "estimated_amount": 6278, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 5707.79, "standard_charge_percentage": 50.0000, "estimated_amount": 5707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 4518.28, "estimated_amount": 4518, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2973.32, "estimated_amount": 2973, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 8244.33, "standard_charge_percentage": 78.5000, "estimated_amount": 8244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 8692.39, "standard_charge_percentage": 78.5000, "estimated_amount": 8692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2885.87, "estimated_amount": 2885, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 5707.79, "standard_charge_percentage": 50.0000, "estimated_amount": 5707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 9988.63, "standard_charge_percentage": 87.5000, "estimated_amount": 9988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 8692.39, "standard_charge_percentage": 78.5000, "estimated_amount": 8692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 8961.23, "standard_charge_percentage": 78.5000, "estimated_amount": 8961, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5707.79, "standard_charge_percentage": 50.0000, "estimated_amount": 5707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 6775.99, "estimated_amount": 6775, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 9703.24, "standard_charge_percentage": 85.0000, "estimated_amount": 9703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 8513.17, "standard_charge_percentage": 78.5000, "estimated_amount": 8513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 8871.62, "standard_charge_percentage": 78.5000, "estimated_amount": 8871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3424.67, "standard_charge_percentage": 30.0000, "estimated_amount": 3424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4081.03, "estimated_amount": 4081, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 4520.57, "standard_charge_percentage": 39.6000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 11415.6, "standard_charge_percentage": 100.0000, "estimated_amount": 11415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 10844.8, "standard_charge_percentage": 95.0000, "estimated_amount": 10844, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2769.27, "estimated_amount": 2769, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 8065.11, "standard_charge_percentage": 78.5000, "estimated_amount": 8065, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 8692.39, "standard_charge_percentage": 78.5000, "estimated_amount": 8692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4566.23, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 8513.17, "standard_charge_percentage": 78.5000, "estimated_amount": 8513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 4518.28, "estimated_amount": 4518, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 10274, "standard_charge_percentage": 90.0000, "estimated_amount": 10274, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 10274, "standard_charge_percentage": 90.0000, "estimated_amount": 10274, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 8692.39, "standard_charge_percentage": 78.5000, "estimated_amount": 8692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 8961.23, "standard_charge_percentage": 78.5000, "estimated_amount": 8961, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2944.17, "estimated_amount": 2944, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5830.04, "estimated_amount": 5830, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 8961.23, "standard_charge_percentage": 78.5000, "estimated_amount": 8961, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 9703.24, "standard_charge_percentage": 85.0000, "estimated_amount": 9703, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 8692.39, "standard_charge_percentage": 78.5000, "estimated_amount": 8692, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 11187.3, "standard_charge_percentage": 98.0000, "estimated_amount": 11187, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 9132.46, "standard_charge_percentage": 80.0000, "estimated_amount": 9132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 10274, "standard_charge_percentage": 90.0000, "estimated_amount": 10274, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Nasal Septal Fx", "code_information": [ { "code": "21337", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4543.99, "discounted_cash": 3787,"minimum": 243.24,"maximum": 4543.99,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3531.36, "standard_charge_percentage": 78.5000, "estimated_amount": 3531, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3210.33, "standard_charge_percentage": 78.5000, "estimated_amount": 3210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2942.77, "estimated_amount": 2942, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4079.08, "estimated_amount": 4079, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3281.67, "standard_charge_percentage": 78.5000, "estimated_amount": 3281, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2271.99, "standard_charge_percentage": 50.0000, "estimated_amount": 2271, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3460.02, "standard_charge_percentage": 78.5000, "estimated_amount": 3460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 4516.13, "estimated_amount": 4516, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1799.42, "standard_charge_percentage": 39.6000, "estimated_amount": 1799, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3975.99, "standard_charge_percentage": 87.5000, "estimated_amount": 3975, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3567.03, "standard_charge_percentage": 78.5000, "estimated_amount": 3567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3460.02, "standard_charge_percentage": 78.5000, "estimated_amount": 3460, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4453.11, "standard_charge_percentage": 98.0000, "estimated_amount": 4453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4316.79, "standard_charge_percentage": 95.0000, "estimated_amount": 4316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3388.68, "standard_charge_percentage": 78.5000, "estimated_amount": 3388, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 4516.13, "estimated_amount": 4516, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3567.03, "standard_charge_percentage": 78.5000, "estimated_amount": 3567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4089.59, "standard_charge_percentage": 90.0000, "estimated_amount": 4089, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4089.59, "standard_charge_percentage": 90.0000, "estimated_amount": 4089, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2271.99, "standard_charge_percentage": 50.0000, "estimated_amount": 2271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2884.49, "estimated_amount": 2884, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4543.99, "standard_charge_percentage": 100.0000, "estimated_amount": 4543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3567.03, "standard_charge_percentage": 78.5000, "estimated_amount": 3567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2971.9, "estimated_amount": 2971, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2271.99, "standard_charge_percentage": 50.0000, "estimated_amount": 2271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 4543.99, "estimated_amount": 4543, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2499.19, "standard_charge_percentage": 55.0000, "estimated_amount": 2499, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3460.02, "standard_charge_percentage": 78.5000, "estimated_amount": 3460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3460.02, "standard_charge_percentage": 78.5000, "estimated_amount": 3460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3407.99, "standard_charge_percentage": 75.0000, "estimated_amount": 3407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2726.39, "standard_charge_percentage": 60.0000, "estimated_amount": 2726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3862.39, "standard_charge_percentage": 85.0000, "estimated_amount": 3862, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3460.02, "standard_charge_percentage": 78.5000, "estimated_amount": 3460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4316.79, "standard_charge_percentage": 95.0000, "estimated_amount": 4316, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1171.85, "estimated_amount": 1171, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4089.59, "standard_charge_percentage": 90.0000, "estimated_amount": 4089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2767.95, "estimated_amount": 2767, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1363.2, "standard_charge_percentage": 30.0000, "estimated_amount": 1363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3388.68, "standard_charge_percentage": 78.5000, "estimated_amount": 3388, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3862.39, "standard_charge_percentage": 85.0000, "estimated_amount": 3862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2017.53, "standard_charge_percentage": 44.4000, "estimated_amount": 2017, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3635.19, "standard_charge_percentage": 80.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Nose/Jaw Fracw Dent Wires Fix", "code_information": [ { "code": "21345", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9731, "discounted_cash": 1730,"minimum": 374.23,"maximum": 9731,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1264.27, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 8271.35, "standard_charge_percentage": 85.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1317.5, "estimated_amount": 1317, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9536.38, "standard_charge_percentage": 98.0000, "estimated_amount": 9536, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7562.45, "standard_charge_percentage": 78.5000, "estimated_amount": 7562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8514.63, "standard_charge_percentage": 87.5000, "estimated_amount": 8514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 9244.45, "standard_charge_percentage": 95.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 7256.89, "standard_charge_percentage": 78.5000, "estimated_amount": 7256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 9244.45, "standard_charge_percentage": 95.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3853.48, "standard_charge_percentage": 39.6000, "estimated_amount": 3853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6874.95, "standard_charge_percentage": 78.5000, "estimated_amount": 6874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2919.3, "standard_charge_percentage": 30.0000, "estimated_amount": 2919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2452.6, "estimated_amount": 2452, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2661.62, "estimated_amount": 2661, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5352.05, "standard_charge_percentage": 55.0000, "estimated_amount": 5352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 8271.35, "standard_charge_percentage": 85.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 7256.89, "standard_charge_percentage": 78.5000, "estimated_amount": 7256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1357.43, "estimated_amount": 1357, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 5838.6, "standard_charge_percentage": 60.0000, "estimated_amount": 5838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9731, "standard_charge_percentage": 100.0000, "estimated_amount": 9731, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4320.56, "standard_charge_percentage": 44.4000, "estimated_amount": 4320, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 7027.73, "standard_charge_percentage": 78.5000, "estimated_amount": 7027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1863.13, "estimated_amount": 1863, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 7298.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1344.12, "estimated_amount": 1344, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Fx Orbit Wo Manip", "code_information": [ { "code": "21400", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3448.15, "discounted_cash": 594,"minimum": 325.58,"maximum": 3448.15,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2625.59, "standard_charge_percentage": 78.5000, "estimated_amount": 2625, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3103.34, "standard_charge_percentage": 90.0000, "estimated_amount": 3103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 434.64, "estimated_amount": 434, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1034.44, "standard_charge_percentage": 30.0000, "estimated_amount": 1034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2068.89, "standard_charge_percentage": 60.0000, "estimated_amount": 2068, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3275.74, "standard_charge_percentage": 95.0000, "estimated_amount": 3275, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3379.19, "standard_charge_percentage": 98.0000, "estimated_amount": 3379, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2625.59, "standard_charge_percentage": 78.5000, "estimated_amount": 2625, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 640.53, "estimated_amount": 640, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2625.59, "standard_charge_percentage": 78.5000, "estimated_amount": 2625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3017.13, "standard_charge_percentage": 87.5000, "estimated_amount": 3017, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1530.98, "standard_charge_percentage": 44.4000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 915.04, "estimated_amount": 915, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2679.73, "standard_charge_percentage": 78.5000, "estimated_amount": 2679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2571.46, "standard_charge_percentage": 78.5000, "estimated_amount": 2571, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2930.93, "standard_charge_percentage": 85.0000, "estimated_amount": 2930, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1171.85, "estimated_amount": 1171, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3275.74, "standard_charge_percentage": 95.0000, "estimated_amount": 3275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2930.93, "standard_charge_percentage": 85.0000, "estimated_amount": 2930, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 709.16, "estimated_amount": 709, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2490.25, "standard_charge_percentage": 78.5000, "estimated_amount": 2490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1724.08, "standard_charge_percentage": 50.0000, "estimated_amount": 1724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3448.15, "standard_charge_percentage": 100.0000, "estimated_amount": 3448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1724.08, "standard_charge_percentage": 50.0000, "estimated_amount": 1724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2625.59, "standard_charge_percentage": 78.5000, "estimated_amount": 2625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2625.59, "standard_charge_percentage": 78.5000, "estimated_amount": 2625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1896.48, "standard_charge_percentage": 55.0000, "estimated_amount": 1896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2706.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2706, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2706.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1724.08, "standard_charge_percentage": 50.0000, "estimated_amount": 1724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3103.34, "standard_charge_percentage": 90.0000, "estimated_amount": 3103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2586.11, "standard_charge_percentage": 75.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2706.8, "standard_charge_percentage": 78.5000, "estimated_amount": 2706, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 709.16, "estimated_amount": 709, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 466.67, "estimated_amount": 466, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2436.12, "standard_charge_percentage": 78.5000, "estimated_amount": 2436, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1365.47, "standard_charge_percentage": 39.6000, "estimated_amount": 1365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2571.46, "standard_charge_percentage": 78.5000, "estimated_amount": 2571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3103.34, "standard_charge_percentage": 90.0000, "estimated_amount": 3103, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 462.1, "estimated_amount": 462, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 452.94, "estimated_amount": 452, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2758.52, "standard_charge_percentage": 80.0000, "estimated_amount": 2758, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Fx Orbit W Manip", "code_information": [ { "code": "21401", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3233.3, "discounted_cash": 1730,"minimum": 374.23,"maximum": 3233.3,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3071.64, "standard_charge_percentage": 95.0000, "estimated_amount": 3071, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2462, "standard_charge_percentage": 78.5000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1939.98, "standard_charge_percentage": 60.0000, "estimated_amount": 1939, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1616.65, "standard_charge_percentage": 50.0000, "estimated_amount": 1616, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2335.09, "standard_charge_percentage": 78.5000, "estimated_amount": 2335, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2284.33, "standard_charge_percentage": 78.5000, "estimated_amount": 2284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3071.64, "standard_charge_percentage": 95.0000, "estimated_amount": 3071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2424.97, "standard_charge_percentage": 75.0000, "estimated_amount": 2424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1357.43, "estimated_amount": 1357, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2909.97, "standard_charge_percentage": 90.0000, "estimated_amount": 2909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2411.23, "standard_charge_percentage": 78.5000, "estimated_amount": 2411, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2909.97, "standard_charge_percentage": 90.0000, "estimated_amount": 2909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3233.3, "standard_charge_percentage": 100.0000, "estimated_amount": 3233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1616.65, "standard_charge_percentage": 50.0000, "estimated_amount": 1616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 969.99, "standard_charge_percentage": 30.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2462, "standard_charge_percentage": 78.5000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2512.76, "standard_charge_percentage": 78.5000, "estimated_amount": 2512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2538.14, "standard_charge_percentage": 78.5000, "estimated_amount": 2538, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1344.12, "estimated_amount": 1344, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 1171.85, "estimated_amount": 1171, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2538.14, "standard_charge_percentage": 78.5000, "estimated_amount": 2538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2909.97, "standard_charge_percentage": 90.0000, "estimated_amount": 2909, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2748.3, "standard_charge_percentage": 85.0000, "estimated_amount": 2748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2748.3, "standard_charge_percentage": 85.0000, "estimated_amount": 2748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1778.32, "standard_charge_percentage": 55.0000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1616.65, "standard_charge_percentage": 50.0000, "estimated_amount": 1616, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1280.39, "standard_charge_percentage": 39.6000, "estimated_amount": 1280, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2538.14, "standard_charge_percentage": 78.5000, "estimated_amount": 2538, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2462, "standard_charge_percentage": 78.5000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2411.23, "standard_charge_percentage": 78.5000, "estimated_amount": 2411, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2661.62, "estimated_amount": 2661, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1863.13, "estimated_amount": 1863, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2829.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1317.5, "estimated_amount": 1317, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1435.59, "standard_charge_percentage": 44.4000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2462, "standard_charge_percentage": 78.5000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3168.63, "standard_charge_percentage": 98.0000, "estimated_amount": 3168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1264.27, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2462, "standard_charge_percentage": 78.5000, "estimated_amount": 2462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2586.64, "standard_charge_percentage": 80.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Leforte I+Wires", "code_information": [ { "code": "21421", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18650.2, "discounted_cash": 3787,"minimum": 460.29,"maximum": 18650.2,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 13908.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13908, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9325.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9325, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 18277.2, "standard_charge_percentage": 98.0000, "estimated_amount": 18277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2942.77, "estimated_amount": 2942, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5827.26, "estimated_amount": 5827, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14201.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 13908.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13176.4, "standard_charge_percentage": 78.5000, "estimated_amount": 13176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14201.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 4516.13, "estimated_amount": 4516, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2971.9, "estimated_amount": 2971, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 11190.1, "standard_charge_percentage": 60.0000, "estimated_amount": 11190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 16785.2, "standard_charge_percentage": 90.0000, "estimated_amount": 16785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4079.08, "estimated_amount": 4079, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14201.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 17717.7, "standard_charge_percentage": 95.0000, "estimated_amount": 17717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14201.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 8280.69, "standard_charge_percentage": 44.4000, "estimated_amount": 8280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 18650.2, "standard_charge_percentage": 100.0000, "estimated_amount": 18650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5595.06, "standard_charge_percentage": 30.0000, "estimated_amount": 5595, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 4516.13, "estimated_amount": 4516, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 16785.2, "standard_charge_percentage": 90.0000, "estimated_amount": 16785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 14640.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 460.29, "estimated_amount": 460, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3604.26, "estimated_amount": 3604, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 13469.2, "standard_charge_percentage": 78.5000, "estimated_amount": 13469, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 15852.7, "standard_charge_percentage": 85.0000, "estimated_amount": 15852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 14640.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 14494, "standard_charge_percentage": 78.5000, "estimated_amount": 14494, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9325.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9325, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7385.48, "standard_charge_percentage": 39.6000, "estimated_amount": 7385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 15852.7, "standard_charge_percentage": 85.0000, "estimated_amount": 15852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 17717.7, "standard_charge_percentage": 95.0000, "estimated_amount": 17717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14201.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 16318.9, "standard_charge_percentage": 87.5000, "estimated_amount": 16318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2884.49, "estimated_amount": 2884, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9325.1, "standard_charge_percentage": 50.0000, "estimated_amount": 9325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2767.95, "estimated_amount": 2767, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 16785.2, "standard_charge_percentage": 90.0000, "estimated_amount": 16785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10257.6, "standard_charge_percentage": 55.0000, "estimated_amount": 10257, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 13987.7, "standard_charge_percentage": 75.0000, "estimated_amount": 13987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14640.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14920.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14920, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Leforte Iii+Wires", "code_information": [ { "code": "21431", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9731,"minimum": 2919.3,"maximum": 9731,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6874.95, "standard_charge_percentage": 78.5000, "estimated_amount": 6874, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 7027.73, "standard_charge_percentage": 78.5000, "estimated_amount": 7027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 5838.6, "standard_charge_percentage": 60.0000, "estimated_amount": 5838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9731, "standard_charge_percentage": 100.0000, "estimated_amount": 9731, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 7298.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7562.45, "standard_charge_percentage": 78.5000, "estimated_amount": 7562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 7256.89, "standard_charge_percentage": 78.5000, "estimated_amount": 7256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 7256.89, "standard_charge_percentage": 78.5000, "estimated_amount": 7256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 9244.45, "standard_charge_percentage": 95.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3853.48, "standard_charge_percentage": 39.6000, "estimated_amount": 3853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8514.63, "standard_charge_percentage": 87.5000, "estimated_amount": 8514, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 8271.35, "standard_charge_percentage": 85.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 5682.6, "estimated_amount": 5682, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4320.56, "standard_charge_percentage": 44.4000, "estimated_amount": 4320, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9536.38, "standard_charge_percentage": 98.0000, "estimated_amount": 9536, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 9244.45, "standard_charge_percentage": 95.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5352.05, "standard_charge_percentage": 55.0000, "estimated_amount": 5352, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4316, "estimated_amount": 4316, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 8271.35, "standard_charge_percentage": 85.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2919.3, "standard_charge_percentage": 30.0000, "estimated_amount": 2919, "methodology": "percent of total billed charges" }]}]} , { "description": "TREAT DENTAL RIDGE FRACTURE", "code_information": [ { "code": "21440", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9731, "discounted_cash": 3787,"minimum": 440.8,"maximum": 9731,"payers_information":[{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2884.49, "estimated_amount": 2884, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2919.3, "standard_charge_percentage": 30.0000, "estimated_amount": 2919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5352.05, "standard_charge_percentage": 55.0000, "estimated_amount": 5352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4320.56, "standard_charge_percentage": 44.4000, "estimated_amount": 4320, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9536.38, "standard_charge_percentage": 98.0000, "estimated_amount": 9536, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 8271.35, "standard_charge_percentage": 85.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2767.95, "estimated_amount": 2767, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3604.26, "estimated_amount": 3604, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 8271.35, "standard_charge_percentage": 85.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 440.8, "estimated_amount": 440, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 4516.13, "estimated_amount": 4516, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3853.48, "standard_charge_percentage": 39.6000, "estimated_amount": 3853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 9244.45, "standard_charge_percentage": 95.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7562.45, "standard_charge_percentage": 78.5000, "estimated_amount": 7562, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5827.26, "estimated_amount": 5827, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 7256.89, "standard_charge_percentage": 78.5000, "estimated_amount": 7256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 7256.89, "standard_charge_percentage": 78.5000, "estimated_amount": 7256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 9244.45, "standard_charge_percentage": 95.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 7298.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7298, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 7027.73, "standard_charge_percentage": 78.5000, "estimated_amount": 7027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2913.63, "estimated_amount": 2913, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2942.77, "estimated_amount": 2942, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2971.9, "estimated_amount": 2971, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 440.8, "estimated_amount": 440, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 4516.13, "estimated_amount": 4516, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8514.63, "standard_charge_percentage": 87.5000, "estimated_amount": 8514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9731, "standard_charge_percentage": 100.0000, "estimated_amount": 9731, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 5838.6, "standard_charge_percentage": 60.0000, "estimated_amount": 5838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6874.95, "standard_charge_percentage": 78.5000, "estimated_amount": 6874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4079.08, "estimated_amount": 4079, "methodology": "fee schedule" }]}]} , { "description": "TREAT LOWER JAW FRACTURE", "code_information": [ { "code": "21450", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 926, "discounted_cash": 594,"minimum": 243.24,"maximum": 926,"payers_information":[{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 462.1, "estimated_amount": 462, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 463, "standard_charge_percentage": 50.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 694.5, "standard_charge_percentage": 75.0000, "estimated_amount": 694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 879.7, "standard_charge_percentage": 95.0000, "estimated_amount": 879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 705.1, "standard_charge_percentage": 78.5000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 787.1, "standard_charge_percentage": 85.0000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 640.53, "estimated_amount": 640, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 463, "standard_charge_percentage": 50.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 452.94, "estimated_amount": 452, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 705.1, "standard_charge_percentage": 78.5000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 709.16, "estimated_amount": 709, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 726.91, "standard_charge_percentage": 78.5000, "estimated_amount": 726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 654.22, "standard_charge_percentage": 78.5000, "estimated_amount": 654, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 411.14, "standard_charge_percentage": 44.4000, "estimated_amount": 411, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 463, "standard_charge_percentage": 50.0000, "estimated_amount": 463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 668.76, "standard_charge_percentage": 78.5000, "estimated_amount": 668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 810.25, "standard_charge_percentage": 87.5000, "estimated_amount": 810, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 879.7, "standard_charge_percentage": 95.0000, "estimated_amount": 879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 726.91, "standard_charge_percentage": 78.5000, "estimated_amount": 726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 705.1, "standard_charge_percentage": 78.5000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 277.8, "standard_charge_percentage": 30.0000, "estimated_amount": 277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 434.64, "estimated_amount": 434, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 366.7, "standard_charge_percentage": 39.6000, "estimated_amount": 366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 787.1, "standard_charge_percentage": 85.0000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 690.56, "standard_charge_percentage": 78.5000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 833.4, "standard_charge_percentage": 90.0000, "estimated_amount": 833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 509.3, "standard_charge_percentage": 55.0000, "estimated_amount": 509, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 726.91, "standard_charge_percentage": 78.5000, "estimated_amount": 726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 719.64, "standard_charge_percentage": 78.5000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 915.04, "estimated_amount": 915, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 690.56, "standard_charge_percentage": 78.5000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 466.67, "estimated_amount": 466, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 833.4, "standard_charge_percentage": 90.0000, "estimated_amount": 833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 705.1, "standard_charge_percentage": 78.5000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 926, "standard_charge_percentage": 100.0000, "estimated_amount": 926, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 705.1, "standard_charge_percentage": 78.5000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 709.16, "estimated_amount": 709, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 926, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 555.6, "standard_charge_percentage": 60.0000, "estimated_amount": 555, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 457.52, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 833.4, "standard_charge_percentage": 90.0000, "estimated_amount": 833, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 740.8, "standard_charge_percentage": 80.0000, "estimated_amount": 740, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 907.48, "standard_charge_percentage": 98.0000, "estimated_amount": 907, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Mandible Fx W Manip", "code_information": [ { "code": "21451", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4502, "discounted_cash": 1730,"minimum": 374.23,"maximum": 4502,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4051.8, "standard_charge_percentage": 90.0000, "estimated_amount": 4051, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1863.13, "estimated_amount": 1863, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2452.6, "estimated_amount": 2452, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3180.66, "standard_charge_percentage": 78.5000, "estimated_amount": 3180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4276.9, "standard_charge_percentage": 95.0000, "estimated_amount": 4276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4051.8, "standard_charge_percentage": 90.0000, "estimated_amount": 4051, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3357.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1344.12, "estimated_amount": 1344, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2251, "standard_charge_percentage": 50.0000, "estimated_amount": 2251, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3498.73, "standard_charge_percentage": 78.5000, "estimated_amount": 3498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3357.37, "standard_charge_percentage": 78.5000, "estimated_amount": 3357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3534.07, "standard_charge_percentage": 78.5000, "estimated_amount": 3534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1357.43, "estimated_amount": 1357, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3826.7, "standard_charge_percentage": 85.0000, "estimated_amount": 3826, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1782.79, "standard_charge_percentage": 39.6000, "estimated_amount": 1782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1998.89, "standard_charge_percentage": 44.4000, "estimated_amount": 1998, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2661.62, "estimated_amount": 2661, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3939.25, "standard_charge_percentage": 87.5000, "estimated_amount": 3939, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2476.1, "standard_charge_percentage": 55.0000, "estimated_amount": 2476, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1350.6, "standard_charge_percentage": 30.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3534.07, "standard_charge_percentage": 78.5000, "estimated_amount": 3534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2251, "standard_charge_percentage": 50.0000, "estimated_amount": 2251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3428.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3826.7, "standard_charge_percentage": 85.0000, "estimated_amount": 3826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3376.5, "standard_charge_percentage": 75.0000, "estimated_amount": 3376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1264.27, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3534.07, "standard_charge_percentage": 78.5000, "estimated_amount": 3534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4051.8, "standard_charge_percentage": 90.0000, "estimated_amount": 4051, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3428.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4276.9, "standard_charge_percentage": 95.0000, "estimated_amount": 4276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1317.5, "estimated_amount": 1317, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2701.2, "standard_charge_percentage": 60.0000, "estimated_amount": 2701, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3428.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3428.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3428, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4411.96, "standard_charge_percentage": 98.0000, "estimated_amount": 4411, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3251.34, "standard_charge_percentage": 78.5000, "estimated_amount": 3251, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2251, "standard_charge_percentage": 50.0000, "estimated_amount": 2251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3428.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3601.6, "standard_charge_percentage": 80.0000, "estimated_amount": 3601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4502, "standard_charge_percentage": 100.0000, "estimated_amount": 4502, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Mandible Fx W Dental Fix", "code_information": [ { "code": "21453", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7597.06, "discounted_cash": 6909,"minimum": 374.23,"maximum": 7597.06,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5784.78, "standard_charge_percentage": 78.5000, "estimated_amount": 5784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7597.06, "standard_charge_percentage": 100.0000, "estimated_amount": 7597, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3008.44, "standard_charge_percentage": 39.6000, "estimated_amount": 3008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 7217.21, "standard_charge_percentage": 95.0000, "estimated_amount": 7217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5784.78, "standard_charge_percentage": 78.5000, "estimated_amount": 5784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5697.8, "standard_charge_percentage": 75.0000, "estimated_amount": 5697, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3798.53, "standard_charge_percentage": 50.0000, "estimated_amount": 3798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 7440.64, "estimated_amount": 7440, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5784.78, "standard_charge_percentage": 78.5000, "estimated_amount": 5784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 4558.24, "standard_charge_percentage": 60.0000, "estimated_amount": 4558, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6457.5, "standard_charge_percentage": 85.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3373.09, "standard_charge_percentage": 44.4000, "estimated_amount": 3373, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5963.69, "standard_charge_percentage": 78.5000, "estimated_amount": 5963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2279.12, "standard_charge_percentage": 30.0000, "estimated_amount": 2279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6457.5, "standard_charge_percentage": 85.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 7597.06, "estimated_amount": 7597, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 7597.06, "estimated_amount": 7597, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 7597.06, "estimated_amount": 7597, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6837.35, "standard_charge_percentage": 90.0000, "estimated_amount": 6837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5963.69, "standard_charge_percentage": 78.5000, "estimated_amount": 5963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5904.06, "standard_charge_percentage": 78.5000, "estimated_amount": 5904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5665.51, "standard_charge_percentage": 78.5000, "estimated_amount": 5665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 5049, "estimated_amount": 5049, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5784.78, "standard_charge_percentage": 78.5000, "estimated_amount": 5784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6647.43, "standard_charge_percentage": 87.5000, "estimated_amount": 6647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 5421.03, "estimated_amount": 5421, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6837.35, "standard_charge_percentage": 90.0000, "estimated_amount": 6837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 5367.89, "estimated_amount": 5367, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5486.6, "standard_charge_percentage": 78.5000, "estimated_amount": 5486, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3798.53, "standard_charge_percentage": 50.0000, "estimated_amount": 3798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5367.32, "standard_charge_percentage": 78.5000, "estimated_amount": 5367, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4316, "estimated_amount": 4316, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5963.69, "standard_charge_percentage": 78.5000, "estimated_amount": 5963, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 7217.21, "standard_charge_percentage": 95.0000, "estimated_amount": 7217, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 5037.25, "estimated_amount": 5037, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4178.38, "standard_charge_percentage": 55.0000, "estimated_amount": 4178, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 5261.59, "estimated_amount": 5261, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3798.53, "standard_charge_percentage": 50.0000, "estimated_amount": 3798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5784.78, "standard_charge_percentage": 78.5000, "estimated_amount": 5784, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 5314.74, "estimated_amount": 5314, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6837.35, "standard_charge_percentage": 90.0000, "estimated_amount": 6837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6077.65, "standard_charge_percentage": 80.0000, "estimated_amount": 6077, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 7445.12, "standard_charge_percentage": 98.0000, "estimated_amount": 7445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5665.51, "standard_charge_percentage": 78.5000, "estimated_amount": 5665, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Temporomandibl Disloc", "code_information": [ { "code": "21480", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 560.5, "discounted_cash": 280,"minimum": 141.72,"maximum": 560.5,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 426.79, "standard_charge_percentage": 78.5000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 426.79, "standard_charge_percentage": 78.5000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 417.99, "standard_charge_percentage": 78.5000, "estimated_amount": 417, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 549.29, "standard_charge_percentage": 98.0000, "estimated_amount": 549, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 141.72, "estimated_amount": 141, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 504.45, "standard_charge_percentage": 90.0000, "estimated_amount": 504, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 404.79, "standard_charge_percentage": 78.5000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 490.44, "standard_charge_percentage": 87.5000, "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 334.04, "estimated_amount": 334, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 476.43, "standard_charge_percentage": 85.0000, "estimated_amount": 476, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 168.15, "standard_charge_percentage": 30.0000, "estimated_amount": 168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 420.38, "standard_charge_percentage": 75.0000, "estimated_amount": 420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 532.48, "standard_charge_percentage": 95.0000, "estimated_amount": 532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 204.73, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 560.5, "standard_charge_percentage": 100.0000, "estimated_amount": 560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 426.79, "standard_charge_percentage": 78.5000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 219.82, "estimated_amount": 219, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 280.25, "standard_charge_percentage": 50.0000, "estimated_amount": 280, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 221.96, "standard_charge_percentage": 39.6000, "estimated_amount": 221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 417.99, "standard_charge_percentage": 78.5000, "estimated_amount": 417, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 435.59, "standard_charge_percentage": 78.5000, "estimated_amount": 435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 213.35, "estimated_amount": 213, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 504.45, "standard_charge_percentage": 90.0000, "estimated_amount": 504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 308.27, "standard_charge_percentage": 55.0000, "estimated_amount": 308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 431.02, "estimated_amount": 431, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 426.79, "standard_charge_percentage": 78.5000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 439.99, "standard_charge_percentage": 78.5000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 448.4, "standard_charge_percentage": 80.0000, "estimated_amount": 448, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 334.04, "estimated_amount": 334, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 248.86, "standard_charge_percentage": 44.4000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 504.45, "standard_charge_percentage": 90.0000, "estimated_amount": 504, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 280.25, "standard_charge_percentage": 50.0000, "estimated_amount": 280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 301.71, "estimated_amount": 301, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 532.48, "standard_charge_percentage": 95.0000, "estimated_amount": 532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 439.99, "standard_charge_percentage": 78.5000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 476.43, "standard_charge_percentage": 85.0000, "estimated_amount": 476, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 439.99, "standard_charge_percentage": 78.5000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 336.3, "standard_charge_percentage": 60.0000, "estimated_amount": 336, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 217.67, "estimated_amount": 217, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 426.79, "standard_charge_percentage": 78.5000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 395.99, "standard_charge_percentage": 78.5000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 280.25, "standard_charge_percentage": 50.0000, "estimated_amount": 280, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Temporomandibl Disloc Complic", "code_information": [ { "code": "21485", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9731, "discounted_cash": 1730,"minimum": 243.24,"maximum": 9731,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1317.5, "estimated_amount": 1317, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9536.38, "standard_charge_percentage": 98.0000, "estimated_amount": 9536, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5352.05, "standard_charge_percentage": 55.0000, "estimated_amount": 5352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1357.43, "estimated_amount": 1357, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8757.9, "standard_charge_percentage": 90.0000, "estimated_amount": 8757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 8271.35, "standard_charge_percentage": 85.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 1863.13, "estimated_amount": 1863, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4320.56, "standard_charge_percentage": 44.4000, "estimated_amount": 4320, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 9244.45, "standard_charge_percentage": 95.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 7298.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 8271.35, "standard_charge_percentage": 85.0000, "estimated_amount": 8271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1344.12, "estimated_amount": 1344, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 7256.89, "standard_charge_percentage": 78.5000, "estimated_amount": 7256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 7256.89, "standard_charge_percentage": 78.5000, "estimated_amount": 7256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9731, "standard_charge_percentage": 100.0000, "estimated_amount": 9731, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3853.48, "standard_charge_percentage": 39.6000, "estimated_amount": 3853, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2452.6, "estimated_amount": 2452, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7638.84, "standard_charge_percentage": 78.5000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 9244.45, "standard_charge_percentage": 95.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2661.62, "estimated_amount": 2661, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7562.45, "standard_charge_percentage": 78.5000, "estimated_amount": 7562, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7784.8, "standard_charge_percentage": 80.0000, "estimated_amount": 7784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 5838.6, "standard_charge_percentage": 60.0000, "estimated_amount": 5838, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6874.95, "standard_charge_percentage": 78.5000, "estimated_amount": 6874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2919.3, "standard_charge_percentage": 30.0000, "estimated_amount": 2919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1330.81, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4865.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8514.63, "standard_charge_percentage": 87.5000, "estimated_amount": 8514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1264.27, "estimated_amount": 1264, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 7027.73, "standard_charge_percentage": 78.5000, "estimated_amount": 7027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2062.76, "estimated_amount": 2062, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7409.67, "standard_charge_percentage": 78.5000, "estimated_amount": 7409, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" }]}]} , { "description": "Hc I&D Deep Absc/Hematoma Neck/Chest", "code_information": [ { "code": "21501", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3193.73, "discounted_cash": 3342,"minimum": 325.58,"maximum": 3193.73,"payers_information":[{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 958.12, "standard_charge_percentage": 30.0000, "estimated_amount": 958, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3034.04, "standard_charge_percentage": 95.0000, "estimated_amount": 3034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1596.87, "standard_charge_percentage": 50.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3034.04, "standard_charge_percentage": 95.0000, "estimated_amount": 3034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2482.01, "standard_charge_percentage": 78.5000, "estimated_amount": 2482, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1916.24, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3129.86, "standard_charge_percentage": 98.0000, "estimated_amount": 3129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2381.72, "standard_charge_percentage": 78.5000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1264.72, "standard_charge_percentage": 39.6000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1756.55, "standard_charge_percentage": 55.0000, "estimated_amount": 1756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 3193.73, "estimated_amount": 3193, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2714.67, "standard_charge_percentage": 85.0000, "estimated_amount": 2714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1277.49, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2507.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2431.87, "standard_charge_percentage": 78.5000, "estimated_amount": 2431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2256.37, "standard_charge_percentage": 78.5000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2306.51, "standard_charge_percentage": 78.5000, "estimated_amount": 2306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2874.36, "standard_charge_percentage": 90.0000, "estimated_amount": 2874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2395.3, "standard_charge_percentage": 75.0000, "estimated_amount": 2395, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2381.72, "standard_charge_percentage": 78.5000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2431.87, "standard_charge_percentage": 78.5000, "estimated_amount": 2431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1596.87, "standard_charge_percentage": 50.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3193.73, "estimated_amount": 3193, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3193.73, "estimated_amount": 3193, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2431.87, "standard_charge_percentage": 78.5000, "estimated_amount": 2431, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2874.36, "standard_charge_percentage": 90.0000, "estimated_amount": 2874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2431.87, "standard_charge_percentage": 78.5000, "estimated_amount": 2431, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2860.88, "estimated_amount": 2860, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2431.87, "standard_charge_percentage": 78.5000, "estimated_amount": 2431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2794.51, "standard_charge_percentage": 87.5000, "estimated_amount": 2794, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2554.98, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2507.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2507, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2874.36, "standard_charge_percentage": 90.0000, "estimated_amount": 2874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3193.73, "estimated_amount": 3193, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3193.73, "standard_charge_percentage": 100.0000, "estimated_amount": 3193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2714.67, "standard_charge_percentage": 85.0000, "estimated_amount": 2714, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1596.87, "standard_charge_percentage": 50.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2507.08, "standard_charge_percentage": 78.5000, "estimated_amount": 2507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" }]}]} , { "description": "Hc Biopsy Soft Tissue Neck/Chest", "code_information": [ { "code": "21550", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6830.25, "discounted_cash": 1892,"minimum": 243.24,"maximum": 6830.25,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6830.25, "standard_charge_percentage": 100.0000, "estimated_amount": 6830, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5308.13, "standard_charge_percentage": 78.5000, "estimated_amount": 5308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2732.1, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2732, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5122.69, "standard_charge_percentage": 75.0000, "estimated_amount": 5122, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4932.81, "standard_charge_percentage": 78.5000, "estimated_amount": 4932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2049.07, "standard_charge_percentage": 30.0000, "estimated_amount": 2049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5093.66, "standard_charge_percentage": 78.5000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5361.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5361, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6693.65, "standard_charge_percentage": 98.0000, "estimated_amount": 6693, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3415.13, "standard_charge_percentage": 50.0000, "estimated_amount": 3415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4825.57, "standard_charge_percentage": 78.5000, "estimated_amount": 4825, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2704.78, "standard_charge_percentage": 39.6000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5976.47, "standard_charge_percentage": 87.5000, "estimated_amount": 5976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2860.88, "estimated_amount": 2860, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6488.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6488, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5200.89, "standard_charge_percentage": 78.5000, "estimated_amount": 5200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3756.64, "standard_charge_percentage": 55.0000, "estimated_amount": 3756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5805.71, "standard_charge_percentage": 85.0000, "estimated_amount": 5805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5464.2, "standard_charge_percentage": 80.0000, "estimated_amount": 5464, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6147.23, "standard_charge_percentage": 90.0000, "estimated_amount": 6147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "21552", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6578.5, "discounted_cash": 3342,"minimum": 243.24,"maximum": 6578.5,"payers_information":[{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5591.73, "standard_charge_percentage": 85.0000, "estimated_amount": 5591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5164.12, "standard_charge_percentage": 78.5000, "estimated_amount": 5164, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5009.2, "standard_charge_percentage": 78.5000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4750.99, "standard_charge_percentage": 78.5000, "estimated_amount": 4750, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5920.65, "standard_charge_percentage": 90.0000, "estimated_amount": 5920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6249.57, "standard_charge_percentage": 95.0000, "estimated_amount": 6249, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3289.25, "standard_charge_percentage": 50.0000, "estimated_amount": 3289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5164.12, "standard_charge_percentage": 78.5000, "estimated_amount": 5164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6578.5, "standard_charge_percentage": 100.0000, "estimated_amount": 6578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5591.73, "standard_charge_percentage": 85.0000, "estimated_amount": 5591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3289.25, "standard_charge_percentage": 50.0000, "estimated_amount": 3289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3289.25, "standard_charge_percentage": 50.0000, "estimated_amount": 3289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5009.2, "standard_charge_percentage": 78.5000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5009.2, "standard_charge_percentage": 78.5000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6446.93, "standard_charge_percentage": 98.0000, "estimated_amount": 6446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5920.65, "standard_charge_percentage": 90.0000, "estimated_amount": 5920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4905.92, "standard_charge_percentage": 78.5000, "estimated_amount": 4905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5112.48, "standard_charge_percentage": 78.5000, "estimated_amount": 5112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2631.4, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2631, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5009.2, "standard_charge_percentage": 78.5000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6249.57, "standard_charge_percentage": 95.0000, "estimated_amount": 6249, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5164.12, "standard_charge_percentage": 78.5000, "estimated_amount": 5164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4933.88, "standard_charge_percentage": 75.0000, "estimated_amount": 4933, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4905.92, "standard_charge_percentage": 78.5000, "estimated_amount": 4905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5756.19, "standard_charge_percentage": 87.5000, "estimated_amount": 5756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5920.65, "standard_charge_percentage": 90.0000, "estimated_amount": 5920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3618.18, "standard_charge_percentage": 55.0000, "estimated_amount": 3618, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2605.09, "standard_charge_percentage": 39.6000, "estimated_amount": 2605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5262.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5262, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2860.88, "estimated_amount": 2860, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1973.55, "standard_charge_percentage": 30.0000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4647.71, "standard_charge_percentage": 78.5000, "estimated_amount": 4647, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5009.2, "standard_charge_percentage": 78.5000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" }]}]} , { "description": "Exc neck les sc < 3 cm", "code_information": [ { "code": "21555", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20014, "discounted_cash": 1892,"minimum": 325.58,"maximum": 20014,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14925.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15553.9, "standard_charge_percentage": 78.5000, "estimated_amount": 15553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14139.9, "standard_charge_percentage": 78.5000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 17011.9, "standard_charge_percentage": 85.0000, "estimated_amount": 17011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 19013.3, "standard_charge_percentage": 95.0000, "estimated_amount": 19013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6004.2, "standard_charge_percentage": 30.0000, "estimated_amount": 6004, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19613.7, "standard_charge_percentage": 98.0000, "estimated_amount": 19613, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14454.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14454, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7925.54, "standard_charge_percentage": 39.6000, "estimated_amount": 7925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 11007.7, "standard_charge_percentage": 55.0000, "estimated_amount": 11007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17512.3, "standard_charge_percentage": 87.5000, "estimated_amount": 17512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 18012.6, "standard_charge_percentage": 90.0000, "estimated_amount": 18012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15711, "standard_charge_percentage": 78.5000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 15010.5, "standard_charge_percentage": 75.0000, "estimated_amount": 15010, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2860.88, "estimated_amount": 2860, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 19013.3, "standard_charge_percentage": 95.0000, "estimated_amount": 19013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 10007, "standard_charge_percentage": 50.0000, "estimated_amount": 10007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14925.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 20014, "standard_charge_percentage": 100.0000, "estimated_amount": 20014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 17011.9, "standard_charge_percentage": 85.0000, "estimated_amount": 17011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16011.2, "standard_charge_percentage": 80.0000, "estimated_amount": 16011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15239.7, "standard_charge_percentage": 78.5000, "estimated_amount": 15239, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc neck tum deep < 5 cm", "code_information": [ { "code": "21556", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 31969.2, "discounted_cash": 3342,"minimum": 374.23,"maximum": 31969.2,"payers_information":[{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 9590.76, "standard_charge_percentage": 30.0000, "estimated_amount": 9590, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 12659.8, "standard_charge_percentage": 39.6000, "estimated_amount": 12659, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 25095.8, "standard_charge_percentage": 78.5000, "estimated_amount": 25095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 28772.3, "standard_charge_percentage": 90.0000, "estimated_amount": 28772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 24343, "standard_charge_percentage": 78.5000, "estimated_amount": 24342, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 15984.6, "standard_charge_percentage": 50.0000, "estimated_amount": 15984, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 25095.8, "standard_charge_percentage": 78.5000, "estimated_amount": 25095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 24343, "standard_charge_percentage": 78.5000, "estimated_amount": 24342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 22586.2, "standard_charge_percentage": 78.5000, "estimated_amount": 22586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 28772.3, "standard_charge_percentage": 90.0000, "estimated_amount": 28772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 24343, "standard_charge_percentage": 78.5000, "estimated_amount": 24342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 23976.9, "standard_charge_percentage": 75.0000, "estimated_amount": 23976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 23841, "standard_charge_percentage": 78.5000, "estimated_amount": 23841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 24844.9, "standard_charge_percentage": 78.5000, "estimated_amount": 24844, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 27173.8, "standard_charge_percentage": 85.0000, "estimated_amount": 27173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 27173.8, "standard_charge_percentage": 85.0000, "estimated_amount": 27173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 31969.2, "standard_charge_percentage": 100.0000, "estimated_amount": 31969, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 31329.8, "standard_charge_percentage": 98.0000, "estimated_amount": 31329, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2860.88, "estimated_amount": 2860, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 25095.8, "standard_charge_percentage": 78.5000, "estimated_amount": 25095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 17583.1, "standard_charge_percentage": 55.0000, "estimated_amount": 17583, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 15984.6, "standard_charge_percentage": 50.0000, "estimated_amount": 15984, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 24343, "standard_charge_percentage": 78.5000, "estimated_amount": 24342, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 23088.2, "standard_charge_percentage": 78.5000, "estimated_amount": 23088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 23841, "standard_charge_percentage": 78.5000, "estimated_amount": 23841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 30370.7, "standard_charge_percentage": 95.0000, "estimated_amount": 30370, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 15984.6, "standard_charge_percentage": 50.0000, "estimated_amount": 15984, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 27973, "standard_charge_percentage": 87.5000, "estimated_amount": 27973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 24343, "standard_charge_percentage": 78.5000, "estimated_amount": 24342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 28772.3, "standard_charge_percentage": 90.0000, "estimated_amount": 28772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 30370.7, "standard_charge_percentage": 95.0000, "estimated_amount": 30370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 374.23, "estimated_amount": 374, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 25575.4, "standard_charge_percentage": 80.0000, "estimated_amount": 25575, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "21601", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19735.5, "discounted_cash": 3342,"minimum": 524.88,"maximum": 19735.5,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 524.88, "estimated_amount": 524, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14717.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5920.65, "standard_charge_percentage": 30.0000, "estimated_amount": 5920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19340.8, "standard_charge_percentage": 98.0000, "estimated_amount": 19340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17268.6, "standard_charge_percentage": 87.5000, "estimated_amount": 17268, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14253, "standard_charge_percentage": 78.5000, "estimated_amount": 14252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7815.26, "standard_charge_percentage": 39.6000, "estimated_amount": 7815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13943.1, "standard_charge_percentage": 78.5000, "estimated_amount": 13943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2860.88, "estimated_amount": 2860, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16775.2, "standard_charge_percentage": 85.0000, "estimated_amount": 16775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14717.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 524.88, "estimated_amount": 524, "methodology": "case rate" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15337.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15337, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19735.5, "standard_charge_percentage": 100.0000, "estimated_amount": 19735, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18748.7, "standard_charge_percentage": 95.0000, "estimated_amount": 18748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15027.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17762, "standard_charge_percentage": 90.0000, "estimated_amount": 17761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14801.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14801, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10854.5, "standard_charge_percentage": 55.0000, "estimated_amount": 10854, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15492.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16775.2, "standard_charge_percentage": 85.0000, "estimated_amount": 16775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18748.7, "standard_charge_percentage": 95.0000, "estimated_amount": 18748, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15788.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9867.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9867, "methodology": "percent of total billed charges" }]}]} , { "description": "TREAT STERNUM FRACTURE", "code_information": [ { "code": "21820", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 845.45, "discounted_cash": 280,"minimum": 204.73,"maximum": 845.45,"payers_information":[{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 828.54, "standard_charge_percentage": 98.0000, "estimated_amount": 828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 739.77, "standard_charge_percentage": 87.5000, "estimated_amount": 739, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 760.9, "standard_charge_percentage": 90.0000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 718.63, "standard_charge_percentage": 85.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 217.67, "estimated_amount": 217, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 431.02, "estimated_amount": 431, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 204.73, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 334.04, "estimated_amount": 334, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 643.77, "standard_charge_percentage": 78.5000, "estimated_amount": 643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 465, "standard_charge_percentage": 55.0000, "estimated_amount": 465, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 566.66, "estimated_amount": 566, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 643.77, "standard_charge_percentage": 78.5000, "estimated_amount": 643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 643.77, "standard_charge_percentage": 78.5000, "estimated_amount": 643, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 610.58, "standard_charge_percentage": 78.5000, "estimated_amount": 610, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 643.77, "standard_charge_percentage": 78.5000, "estimated_amount": 643, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 334.8, "standard_charge_percentage": 39.6000, "estimated_amount": 334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 422.73, "standard_charge_percentage": 50.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 663.68, "standard_charge_percentage": 78.5000, "estimated_amount": 663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 803.18, "standard_charge_percentage": 95.0000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 718.63, "standard_charge_percentage": 85.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 663.68, "standard_charge_percentage": 78.5000, "estimated_amount": 663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 219.82, "estimated_amount": 219, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 301.71, "estimated_amount": 301, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 634.09, "standard_charge_percentage": 75.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 643.77, "standard_charge_percentage": 78.5000, "estimated_amount": 643, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 630.49, "standard_charge_percentage": 78.5000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 375.38, "standard_charge_percentage": 44.4000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 676.36, "standard_charge_percentage": 80.0000, "estimated_amount": 676, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 507.27, "standard_charge_percentage": 60.0000, "estimated_amount": 507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 597.31, "standard_charge_percentage": 78.5000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 253.63, "standard_charge_percentage": 30.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 630.49, "standard_charge_percentage": 78.5000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 663.68, "standard_charge_percentage": 78.5000, "estimated_amount": 663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 760.9, "standard_charge_percentage": 90.0000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 213.35, "estimated_amount": 213, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 657.04, "standard_charge_percentage": 78.5000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 422.73, "standard_charge_percentage": 50.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 422.73, "standard_charge_percentage": 50.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 760.9, "standard_charge_percentage": 90.0000, "estimated_amount": 760, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 334.04, "estimated_amount": 334, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 845.45, "standard_charge_percentage": 100.0000, "estimated_amount": 845, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 803.18, "standard_charge_percentage": 95.0000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" }]}]} , { "description": "Hc Biopsy Soft Tissue Back,Superf", "code_information": [ { "code": "21920", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2825.94, "discounted_cash": 1892,"minimum": 243.24,"maximum": 2825.94,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 2684.64, "standard_charge_percentage": 95.0000, "estimated_amount": 2684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 2151.81, "standard_charge_percentage": 78.5000, "estimated_amount": 2151, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 2196.18, "standard_charge_percentage": 78.5000, "estimated_amount": 2196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2825.94, "estimated_amount": 2825, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 2543.35, "standard_charge_percentage": 90.0000, "estimated_amount": 2543, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1119.07, "standard_charge_percentage": 39.6000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 847.78, "standard_charge_percentage": 30.0000, "estimated_amount": 847, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 1554.27, "standard_charge_percentage": 55.0000, "estimated_amount": 1554, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 2151.81, "standard_charge_percentage": 78.5000, "estimated_amount": 2151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2107.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2107, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1412.97, "standard_charge_percentage": 50.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 2543.35, "standard_charge_percentage": 90.0000, "estimated_amount": 2543, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 1996.53, "standard_charge_percentage": 78.5000, "estimated_amount": 1996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1130.38, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 2402.05, "standard_charge_percentage": 85.0000, "estimated_amount": 2402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 2218.36, "standard_charge_percentage": 78.5000, "estimated_amount": 2218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 2472.7, "standard_charge_percentage": 87.5000, "estimated_amount": 2472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 2825.94, "standard_charge_percentage": 100.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 2769.42, "standard_charge_percentage": 98.0000, "estimated_amount": 2769, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2119.45, "standard_charge_percentage": 75.0000, "estimated_amount": 2119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2107.44, "standard_charge_percentage": 78.5000, "estimated_amount": 2107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1412.97, "standard_charge_percentage": 50.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 2218.36, "standard_charge_percentage": 78.5000, "estimated_amount": 2218, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 909, "estimated_amount": 909, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 2151.81, "standard_charge_percentage": 78.5000, "estimated_amount": 2151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 2151.81, "standard_charge_percentage": 78.5000, "estimated_amount": 2151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2218.36, "standard_charge_percentage": 78.5000, "estimated_amount": 2218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 2402.05, "standard_charge_percentage": 85.0000, "estimated_amount": 2402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 1695.56, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 1695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 2151.81, "standard_charge_percentage": 78.5000, "estimated_amount": 2151, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 2543.35, "standard_charge_percentage": 90.0000, "estimated_amount": 2543, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2040.89, "standard_charge_percentage": 78.5000, "estimated_amount": 2040, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 2684.64, "standard_charge_percentage": 95.0000, "estimated_amount": 2684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1412.97, "standard_charge_percentage": 50.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 2260.75, "standard_charge_percentage": 80.0000, "estimated_amount": 2260, "methodology": "percent of total billed charges" }]}]} , { "description": "BIOPSY SOFT TISSUE OF BACK", "code_information": [ { "code": "21925", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4242.84, "discounted_cash": 1892,"minimum": 243.24,"maximum": 4242.84,"payers_information":[{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3064.18, "standard_charge_percentage": 78.5000, "estimated_amount": 3064, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3230.71, "standard_charge_percentage": 78.5000, "estimated_amount": 3230, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2121.42, "standard_charge_percentage": 50.0000, "estimated_amount": 2121, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2121.42, "standard_charge_percentage": 50.0000, "estimated_amount": 2121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3818.56, "standard_charge_percentage": 90.0000, "estimated_amount": 3818, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3230.71, "standard_charge_percentage": 78.5000, "estimated_amount": 3230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1697.14, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 1697, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2121.42, "standard_charge_percentage": 50.0000, "estimated_amount": 2121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4030.7, "standard_charge_percentage": 95.0000, "estimated_amount": 4030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3182.13, "standard_charge_percentage": 75.0000, "estimated_amount": 3182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3330.63, "standard_charge_percentage": 78.5000, "estimated_amount": 3330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3818.56, "standard_charge_percentage": 90.0000, "estimated_amount": 3818, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2997.57, "standard_charge_percentage": 78.5000, "estimated_amount": 2997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3606.41, "standard_charge_percentage": 85.0000, "estimated_amount": 3606, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3712.49, "standard_charge_percentage": 87.5000, "estimated_amount": 3712, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3330.63, "standard_charge_percentage": 78.5000, "estimated_amount": 3330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3164.1, "standard_charge_percentage": 78.5000, "estimated_amount": 3164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4242.84, "standard_charge_percentage": 100.0000, "estimated_amount": 4242, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1272.85, "standard_charge_percentage": 30.0000, "estimated_amount": 1272, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3818.56, "standard_charge_percentage": 90.0000, "estimated_amount": 3818, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2333.56, "standard_charge_percentage": 55.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3230.71, "standard_charge_percentage": 78.5000, "estimated_amount": 3230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3606.41, "standard_charge_percentage": 85.0000, "estimated_amount": 3606, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3297.32, "standard_charge_percentage": 78.5000, "estimated_amount": 3297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3230.71, "standard_charge_percentage": 78.5000, "estimated_amount": 3230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3394.27, "standard_charge_percentage": 80.0000, "estimated_amount": 3394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3164.1, "standard_charge_percentage": 78.5000, "estimated_amount": 3164, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4030.7, "standard_charge_percentage": 95.0000, "estimated_amount": 4030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4157.98, "standard_charge_percentage": 98.0000, "estimated_amount": 4157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3330.63, "standard_charge_percentage": 78.5000, "estimated_amount": 3330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1680.16, "standard_charge_percentage": 39.6000, "estimated_amount": 1680, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2545.7, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 2545, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3230.71, "standard_charge_percentage": 78.5000, "estimated_amount": 3230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "21930", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9627.08, "discounted_cash": 1892,"minimum": 243.24,"maximum": 9627.08,"payers_information":[{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7330.54, "standard_charge_percentage": 78.5000, "estimated_amount": 7330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7330.54, "standard_charge_percentage": 78.5000, "estimated_amount": 7330, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 8183.02, "standard_charge_percentage": 85.0000, "estimated_amount": 8183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9627.08, "standard_charge_percentage": 100.0000, "estimated_amount": 9627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7330.54, "standard_charge_percentage": 78.5000, "estimated_amount": 7330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 9145.73, "standard_charge_percentage": 95.0000, "estimated_amount": 9145, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6801.53, "standard_charge_percentage": 78.5000, "estimated_amount": 6801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7481.69, "standard_charge_percentage": 78.5000, "estimated_amount": 7481, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6952.68, "standard_charge_percentage": 78.5000, "estimated_amount": 6952, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4813.54, "standard_charge_percentage": 50.0000, "estimated_amount": 4813, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3812.32, "standard_charge_percentage": 39.6000, "estimated_amount": 3812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3850.83, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3850, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7557.26, "standard_charge_percentage": 78.5000, "estimated_amount": 7557, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5294.89, "standard_charge_percentage": 55.0000, "estimated_amount": 5294, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 7220.31, "standard_charge_percentage": 75.0000, "estimated_amount": 7220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 7179.39, "standard_charge_percentage": 78.5000, "estimated_amount": 7179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 7179.39, "standard_charge_percentage": 78.5000, "estimated_amount": 7179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8423.69, "standard_charge_percentage": 87.5000, "estimated_amount": 8423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8664.37, "standard_charge_percentage": 90.0000, "estimated_amount": 8664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4813.54, "standard_charge_percentage": 50.0000, "estimated_amount": 4813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2888.12, "standard_charge_percentage": 30.0000, "estimated_amount": 2888, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 9145.73, "standard_charge_percentage": 95.0000, "estimated_amount": 9145, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7557.26, "standard_charge_percentage": 78.5000, "estimated_amount": 7557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8664.37, "standard_charge_percentage": 90.0000, "estimated_amount": 8664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7330.54, "standard_charge_percentage": 78.5000, "estimated_amount": 7330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8664.37, "standard_charge_percentage": 90.0000, "estimated_amount": 8664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7557.26, "standard_charge_percentage": 78.5000, "estimated_amount": 7557, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4813.54, "standard_charge_percentage": 50.0000, "estimated_amount": 4813, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9434.54, "standard_charge_percentage": 98.0000, "estimated_amount": 9434, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7330.54, "standard_charge_percentage": 78.5000, "estimated_amount": 7330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 8183.02, "standard_charge_percentage": 85.0000, "estimated_amount": 8183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7701.66, "standard_charge_percentage": 80.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" }]}]} , { "description": "Exc back les sc 3 cm/>", "code_information": [ { "code": "21931", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19634.1, "discounted_cash": 1892,"minimum": 243.24,"maximum": 19634.1,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14642.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 2911.3, "estimated_amount": 2911, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14179.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19634.1, "standard_charge_percentage": 100.0000, "estimated_amount": 19634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14725.6, "standard_charge_percentage": 75.0000, "estimated_amount": 14725, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 2037.91, "estimated_amount": 2037, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18652.4, "standard_charge_percentage": 95.0000, "estimated_amount": 18652, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17179.8, "standard_charge_percentage": 87.5000, "estimated_amount": 17179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9817.05, "standard_charge_percentage": 50.0000, "estimated_amount": 9817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13871.5, "standard_charge_percentage": 78.5000, "estimated_amount": 13871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 1382.87, "estimated_amount": 1382, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14642.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16689, "standard_charge_percentage": 85.0000, "estimated_amount": 16688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7775.1, "standard_charge_percentage": 39.6000, "estimated_amount": 7775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10798.8, "standard_charge_percentage": 55.0000, "estimated_amount": 10798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16689, "standard_charge_percentage": 85.0000, "estimated_amount": 16688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5890.23, "standard_charge_percentage": 30.0000, "estimated_amount": 5890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15258.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15258, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14950.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15412.8, "standard_charge_percentage": 78.5000, "estimated_amount": 15412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 1470.21, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 1484.76, "estimated_amount": 1484, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19241.4, "standard_charge_percentage": 98.0000, "estimated_amount": 19241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18652.4, "standard_charge_percentage": 95.0000, "estimated_amount": 18652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17670.7, "standard_charge_percentage": 90.0000, "estimated_amount": 17670, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 2256.26, "estimated_amount": 2256, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15707.3, "standard_charge_percentage": 80.0000, "estimated_amount": 15707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 1441.09, "estimated_amount": 1441, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 1455.65, "estimated_amount": 1455, "methodology": "fee schedule" }]}]} , { "description": "EXC BACK TUM DEEP 5 CM>", "code_information": [ { "code": "21933", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6418.05, "discounted_cash": 3342,"minimum": 325.58,"maximum": 6418.05,"payers_information":[{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4987.79, "standard_charge_percentage": 78.5000, "estimated_amount": 4987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4887.02, "standard_charge_percentage": 78.5000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4887.02, "standard_charge_percentage": 78.5000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2622.75, "estimated_amount": 2622, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5776.24, "standard_charge_percentage": 90.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5038.17, "standard_charge_percentage": 78.5000, "estimated_amount": 5038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4887.02, "standard_charge_percentage": 78.5000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4635.12, "standard_charge_percentage": 78.5000, "estimated_amount": 4635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4813.54, "standard_charge_percentage": 75.0000, "estimated_amount": 4813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4786.26, "standard_charge_percentage": 78.5000, "estimated_amount": 4786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3209.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3209, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1704, "estimated_amount": 1704, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5455.34, "standard_charge_percentage": 85.0000, "estimated_amount": 5455, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6097.15, "standard_charge_percentage": 95.0000, "estimated_amount": 6097, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3529.93, "standard_charge_percentage": 55.0000, "estimated_amount": 3529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2541.55, "standard_charge_percentage": 39.6000, "estimated_amount": 2541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4786.26, "standard_charge_percentage": 78.5000, "estimated_amount": 4786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3209.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6418.05, "standard_charge_percentage": 100.0000, "estimated_amount": 6418, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4887.02, "standard_charge_percentage": 78.5000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6097.15, "standard_charge_percentage": 95.0000, "estimated_amount": 6097, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5615.79, "standard_charge_percentage": 87.5000, "estimated_amount": 5615, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4534.35, "standard_charge_percentage": 78.5000, "estimated_amount": 4534, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3850.83, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3850, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5038.17, "standard_charge_percentage": 78.5000, "estimated_amount": 5038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6289.69, "standard_charge_percentage": 98.0000, "estimated_amount": 6289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2545.61, "estimated_amount": 2545, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5776.24, "standard_charge_percentage": 90.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4887.02, "standard_charge_percentage": 78.5000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5142.64, "estimated_amount": 5142, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5455.34, "standard_charge_percentage": 85.0000, "estimated_amount": 5455, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 3985.55, "estimated_amount": 3985, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5776.24, "standard_charge_percentage": 90.0000, "estimated_amount": 5776, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5038.17, "standard_charge_percentage": 78.5000, "estimated_amount": 5038, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3209.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2567.22, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2567, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2442.75, "estimated_amount": 2442, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 2225.33, "estimated_amount": 2225, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2571.32, "estimated_amount": 2571, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1925.41, "standard_charge_percentage": 30.0000, "estimated_amount": 1925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 3599.85, "estimated_amount": 3599, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5134.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" }]}]} , { "description": "CLOSED TX VERT FX WO MANJ", "code_information": [ { "code": "22310", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1069.15, "discounted_cash": 280,"minimum": 204.73,"maximum": 1069.15,"payers_information":[{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 204.73, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 301.71, "estimated_amount": 301, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 935.51, "standard_charge_percentage": 87.5000, "estimated_amount": 935, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 334.04, "estimated_amount": 334, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 908.78, "standard_charge_percentage": 85.0000, "estimated_amount": 908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 962.24, "standard_charge_percentage": 90.0000, "estimated_amount": 962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 1015.69, "standard_charge_percentage": 95.0000, "estimated_amount": 1015, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 213.35, "estimated_amount": 213, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 801.86, "standard_charge_percentage": 75.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 641.49, "standard_charge_percentage": 60.0000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 566.66, "estimated_amount": 566, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 772.14, "standard_charge_percentage": 78.5000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 431.02, "estimated_amount": 431, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 814.1, "standard_charge_percentage": 78.5000, "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 839.28, "standard_charge_percentage": 78.5000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 830.89, "standard_charge_percentage": 78.5000, "estimated_amount": 830, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 797.32, "standard_charge_percentage": 78.5000, "estimated_amount": 797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 217.67, "estimated_amount": 217, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 334.04, "estimated_amount": 334, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 588.03, "standard_charge_percentage": 55.0000, "estimated_amount": 588, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 1069.15, "standard_charge_percentage": 100.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 814.1, "standard_charge_percentage": 78.5000, "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 962.24, "standard_charge_percentage": 90.0000, "estimated_amount": 962, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 962.24, "standard_charge_percentage": 90.0000, "estimated_amount": 962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 320.75, "standard_charge_percentage": 30.0000, "estimated_amount": 320, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 908.78, "standard_charge_percentage": 85.0000, "estimated_amount": 908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 814.1, "standard_charge_percentage": 78.5000, "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 534.58, "standard_charge_percentage": 50.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 219.82, "estimated_amount": 219, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 839.28, "standard_charge_percentage": 78.5000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 839.28, "standard_charge_percentage": 78.5000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 243.24, "estimated_amount": 243, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 423.38, "standard_charge_percentage": 39.6000, "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 1015.69, "standard_charge_percentage": 95.0000, "estimated_amount": 1015, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 1047.77, "standard_charge_percentage": 98.0000, "estimated_amount": 1047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 474.7, "standard_charge_percentage": 44.4000, "estimated_amount": 474, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 855.32, "standard_charge_percentage": 80.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 814.1, "standard_charge_percentage": 78.5000, "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 755.35, "standard_charge_percentage": 78.5000, "estimated_amount": 755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 814.1, "standard_charge_percentage": 78.5000, "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 215.51, "estimated_amount": 215, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 797.32, "standard_charge_percentage": 78.5000, "estimated_amount": 797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 534.58, "standard_charge_percentage": 50.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 534.58, "standard_charge_percentage": 50.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Vert Body Fx W Manip", "code_information": [ { "code": "22315", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6560.9, "discounted_cash": 3789,"minimum": 325.58,"maximum": 6560.9,"payers_information":[{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2885.87, "estimated_amount": 2885, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5904.81, "standard_charge_percentage": 90.0000, "estimated_amount": 5904, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5150.31, "standard_charge_percentage": 78.5000, "estimated_amount": 5150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4995.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 4518.28, "estimated_amount": 4518, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3280.45, "standard_charge_percentage": 50.0000, "estimated_amount": 3280, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 566.66, "estimated_amount": 566, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3280.45, "standard_charge_percentage": 50.0000, "estimated_amount": 3280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2973.32, "estimated_amount": 2973, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5904.81, "standard_charge_percentage": 90.0000, "estimated_amount": 5904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4738.28, "standard_charge_percentage": 78.5000, "estimated_amount": 4738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2944.17, "estimated_amount": 2944, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5904.81, "standard_charge_percentage": 90.0000, "estimated_amount": 5904, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6429.68, "standard_charge_percentage": 98.0000, "estimated_amount": 6429, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3936.54, "standard_charge_percentage": 60.0000, "estimated_amount": 3936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2769.27, "estimated_amount": 2769, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5830.04, "estimated_amount": 5830, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3608.49, "standard_charge_percentage": 55.0000, "estimated_amount": 3608, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5150.31, "standard_charge_percentage": 78.5000, "estimated_amount": 5150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1968.27, "standard_charge_percentage": 30.0000, "estimated_amount": 1968, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6232.85, "standard_charge_percentage": 95.0000, "estimated_amount": 6232, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5576.77, "standard_charge_percentage": 85.0000, "estimated_amount": 5576, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5098.8, "standard_charge_percentage": 78.5000, "estimated_amount": 5098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5150.31, "standard_charge_percentage": 78.5000, "estimated_amount": 5150, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4995.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4995.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4995, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2598.12, "standard_charge_percentage": 39.6000, "estimated_amount": 2598, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 4518.28, "estimated_amount": 4518, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4995.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4920.68, "standard_charge_percentage": 75.0000, "estimated_amount": 4920, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 1477, "estimated_amount": 1477, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4892.79, "standard_charge_percentage": 78.5000, "estimated_amount": 4892, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5576.77, "standard_charge_percentage": 85.0000, "estimated_amount": 5576, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 325.58, "estimated_amount": 325, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4995.8, "standard_charge_percentage": 78.5000, "estimated_amount": 4995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6560.9, "standard_charge_percentage": 100.0000, "estimated_amount": 6560, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3280.45, "standard_charge_percentage": 50.0000, "estimated_amount": 3280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4081.03, "estimated_amount": 4081, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5248.72, "standard_charge_percentage": 80.0000, "estimated_amount": 5248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6232.85, "standard_charge_percentage": 95.0000, "estimated_amount": 6232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5740.79, "standard_charge_percentage": 87.5000, "estimated_amount": 5740, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4635.28, "standard_charge_percentage": 78.5000, "estimated_amount": 4635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2913.04, "standard_charge_percentage": 44.4000, "estimated_amount": 2913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4892.79, "standard_charge_percentage": 78.5000, "estimated_amount": 4892, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Perq Cervicothoracic Inj", "code_information": [ { "code": "22510", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4200.88, "discounted_cash": 3789,"minimum": 286.51,"maximum": 4200.88,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3150.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3570.75, "standard_charge_percentage": 85.0000, "estimated_amount": 3570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2310.48, "standard_charge_percentage": 55.0000, "estimated_amount": 2310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3132.81, "standard_charge_percentage": 78.5000, "estimated_amount": 3132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1865.19, "standard_charge_percentage": 44.4000, "estimated_amount": 1865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 4200.88, "estimated_amount": 4200, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4116.86, "standard_charge_percentage": 98.0000, "estimated_amount": 4116, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3297.69, "standard_charge_percentage": 78.5000, "estimated_amount": 3297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3297.69, "standard_charge_percentage": 78.5000, "estimated_amount": 3297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3264.71, "standard_charge_percentage": 78.5000, "estimated_amount": 3264, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3570.75, "standard_charge_percentage": 85.0000, "estimated_amount": 3570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3675.77, "standard_charge_percentage": 87.5000, "estimated_amount": 3675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3198.76, "standard_charge_percentage": 78.5000, "estimated_amount": 3198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3198.76, "standard_charge_percentage": 78.5000, "estimated_amount": 3198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2769.27, "estimated_amount": 2769, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1663.55, "standard_charge_percentage": 39.6000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2520.53, "standard_charge_percentage": 60.0000, "estimated_amount": 2520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4081.03, "estimated_amount": 4081, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2100.44, "standard_charge_percentage": 50.0000, "estimated_amount": 2100, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3198.76, "standard_charge_percentage": 78.5000, "estimated_amount": 3198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1260.26, "standard_charge_percentage": 30.0000, "estimated_amount": 1260, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 4200.88, "estimated_amount": 4200, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3132.81, "standard_charge_percentage": 78.5000, "estimated_amount": 3132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2885.87, "estimated_amount": 2885, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3990.84, "standard_charge_percentage": 95.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2944.17, "estimated_amount": 2944, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3033.88, "standard_charge_percentage": 78.5000, "estimated_amount": 3033, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2967.92, "standard_charge_percentage": 78.5000, "estimated_amount": 2967, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3990.84, "standard_charge_percentage": 95.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3297.69, "standard_charge_percentage": 78.5000, "estimated_amount": 3297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2100.44, "standard_charge_percentage": 50.0000, "estimated_amount": 2100, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2100.44, "standard_charge_percentage": 50.0000, "estimated_amount": 2100, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3198.76, "standard_charge_percentage": 78.5000, "estimated_amount": 3198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 4200.88, "standard_charge_percentage": 100.0000, "estimated_amount": 4200, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3198.76, "standard_charge_percentage": 78.5000, "estimated_amount": 3198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2973.32, "estimated_amount": 2973, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3780.79, "standard_charge_percentage": 90.0000, "estimated_amount": 3780, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 4200.88, "estimated_amount": 4200, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 4200.88, "estimated_amount": 4200, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3780.79, "standard_charge_percentage": 90.0000, "estimated_amount": 3780, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3360.7, "standard_charge_percentage": 80.0000, "estimated_amount": 3360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3780.79, "standard_charge_percentage": 90.0000, "estimated_amount": 3780, "methodology": "percent of total billed charges" }]}]} , { "description": "PERQ LUMBOSACRAL INJECTION", "code_information": [ { "code": "22511", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5075.91, "discounted_cash": 3789,"minimum": 286.51,"maximum": 5075.91,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 2953, "estimated_amount": 2953, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3984.59, "standard_charge_percentage": 78.5000, "estimated_amount": 3984, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4314.52, "standard_charge_percentage": 85.0000, "estimated_amount": 4314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3984.59, "standard_charge_percentage": 78.5000, "estimated_amount": 3984, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4568.32, "standard_charge_percentage": 90.0000, "estimated_amount": 4568, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3665.82, "standard_charge_percentage": 78.5000, "estimated_amount": 3665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3944.74, "standard_charge_percentage": 78.5000, "estimated_amount": 3944, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 4518.28, "estimated_amount": 4518, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 5075.91, "estimated_amount": 5075, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3785.36, "standard_charge_percentage": 78.5000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4314.52, "standard_charge_percentage": 85.0000, "estimated_amount": 4314, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4568.32, "standard_charge_percentage": 90.0000, "estimated_amount": 4568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 2769.27, "estimated_amount": 2769, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3865.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3045.55, "standard_charge_percentage": 60.0000, "estimated_amount": 3045, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4568.32, "standard_charge_percentage": 90.0000, "estimated_amount": 4568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 2973.32, "estimated_amount": 2973, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3865.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 4974.39, "standard_charge_percentage": 98.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 2885.87, "estimated_amount": 2885, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2010.06, "standard_charge_percentage": 39.6000, "estimated_amount": 2010, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2253.7, "standard_charge_percentage": 44.4000, "estimated_amount": 2253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3865.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3586.13, "standard_charge_percentage": 78.5000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3865.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3865, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2537.95, "standard_charge_percentage": 50.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3984.59, "standard_charge_percentage": 78.5000, "estimated_amount": 3984, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3806.93, "standard_charge_percentage": 75.0000, "estimated_amount": 3806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 5075.91, "standard_charge_percentage": 100.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 4518.28, "estimated_amount": 4518, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4441.42, "standard_charge_percentage": 87.5000, "estimated_amount": 4441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 4822.11, "standard_charge_percentage": 95.0000, "estimated_amount": 4822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 4081.03, "estimated_amount": 4081, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 5075.91, "estimated_amount": 5075, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2537.95, "standard_charge_percentage": 50.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3865.05, "standard_charge_percentage": 78.5000, "estimated_amount": 3865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4060.73, "standard_charge_percentage": 80.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2944.17, "estimated_amount": 2944, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3785.36, "standard_charge_percentage": 78.5000, "estimated_amount": 3785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 4822.11, "standard_charge_percentage": 95.0000, "estimated_amount": 4822, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1522.77, "standard_charge_percentage": 30.0000, "estimated_amount": 1522, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2537.95, "standard_charge_percentage": 50.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 2915.02, "estimated_amount": 2915, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2791.75, "standard_charge_percentage": 55.0000, "estimated_amount": 2791, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Perq Vertebroplasty Addl Inj", "code_information": [ { "code": "22512", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3950.19,"minimum": 511,"maximum": 3950.19,"payers_information":[{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1185.06, "standard_charge_percentage": 30.0000, "estimated_amount": 1185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 3555.17, "standard_charge_percentage": 90.0000, "estimated_amount": 3555, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 3100.9, "standard_charge_percentage": 78.5000, "estimated_amount": 3100, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 3007.87, "standard_charge_percentage": 78.5000, "estimated_amount": 3007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 3069.89, "standard_charge_percentage": 78.5000, "estimated_amount": 3069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 2790.81, "standard_charge_percentage": 78.5000, "estimated_amount": 2790, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 3357.66, "standard_charge_percentage": 85.0000, "estimated_amount": 3357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3100.9, "standard_charge_percentage": 78.5000, "estimated_amount": 3100, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 1975.1, "standard_charge_percentage": 50.0000, "estimated_amount": 1975, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 2852.83, "standard_charge_percentage": 78.5000, "estimated_amount": 2852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 3456.42, "standard_charge_percentage": 87.5000, "estimated_amount": 3456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2172.6, "standard_charge_percentage": 55.0000, "estimated_amount": 2172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 3752.68, "standard_charge_percentage": 95.0000, "estimated_amount": 3752, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 3007.87, "standard_charge_percentage": 78.5000, "estimated_amount": 3007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 1753.88, "standard_charge_percentage": 44.4000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 3950.19, "estimated_amount": 3950, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 2945.85, "standard_charge_percentage": 78.5000, "estimated_amount": 2945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 2945.85, "standard_charge_percentage": 78.5000, "estimated_amount": 2945, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 3871.19, "standard_charge_percentage": 98.0000, "estimated_amount": 3871, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 1975.1, "standard_charge_percentage": 50.0000, "estimated_amount": 1975, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 3357.66, "standard_charge_percentage": 85.0000, "estimated_amount": 3357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 3950.19, "standard_charge_percentage": 100.0000, "estimated_amount": 3950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 2962.64, "standard_charge_percentage": 75.0000, "estimated_amount": 2962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 3007.87, "standard_charge_percentage": 78.5000, "estimated_amount": 3007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 2370.11, "standard_charge_percentage": 60.0000, "estimated_amount": 2370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 3555.17, "standard_charge_percentage": 90.0000, "estimated_amount": 3555, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3160.15, "standard_charge_percentage": 80.0000, "estimated_amount": 3160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 3752.68, "standard_charge_percentage": 95.0000, "estimated_amount": 3752, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 3100.9, "standard_charge_percentage": 78.5000, "estimated_amount": 3100, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1975.1, "standard_charge_percentage": 50.0000, "estimated_amount": 1975, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 1564.28, "standard_charge_percentage": 39.6000, "estimated_amount": 1564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 3007.87, "standard_charge_percentage": 78.5000, "estimated_amount": 3007, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 3555.17, "standard_charge_percentage": 90.0000, "estimated_amount": 3555, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 3007.87, "standard_charge_percentage": 78.5000, "estimated_amount": 3007, "methodology": "percent of total billed charges" }]}]} , { "description": "PERQ VERTEBRAL AUGMENTATION", "code_information": [ { "code": "22513", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19987.7, "discounted_cash": 8343,"minimum": 286.51,"maximum": 19987.7,"payers_information":[{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 5757, "standard_charge_percentage": 50.0000, "estimated_amount": 5757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 14121.3, "standard_charge_percentage": 78.5000, "estimated_amount": 14121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17988.9, "standard_charge_percentage": 90.0000, "estimated_amount": 17988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18988.3, "standard_charge_percentage": 95.0000, "estimated_amount": 18988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16989.5, "standard_charge_percentage": 85.0000, "estimated_amount": 16989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14905.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 9786.9, "standard_charge_percentage": 85.0000, "estimated_amount": 9786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 8586.57, "standard_charge_percentage": 78.5000, "estimated_amount": 8586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 8586.57, "standard_charge_percentage": 78.5000, "estimated_amount": 8586, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 6908.4, "standard_charge_percentage": 60.0000, "estimated_amount": 6908, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9038.49, "standard_charge_percentage": 78.5000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 11514, "estimated_amount": 11514, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10993.2, "standard_charge_percentage": 55.0000, "estimated_amount": 10993, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7915.13, "standard_charge_percentage": 39.6000, "estimated_amount": 7915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 11514, "standard_charge_percentage": 100.0000, "estimated_amount": 11514, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 15219.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15219, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15690.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 8134.64, "standard_charge_percentage": 78.5000, "estimated_amount": 8134, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 8767.34, "standard_charge_percentage": 78.5000, "estimated_amount": 8767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 6353.88, "estimated_amount": 6353, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5996.31, "standard_charge_percentage": 30.0000, "estimated_amount": 5996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5757, "standard_charge_percentage": 50.0000, "estimated_amount": 5757, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 5936.16, "estimated_amount": 5936, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 6546.42, "estimated_amount": 6546, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15690.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15690, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 5112.22, "standard_charge_percentage": 44.4000, "estimated_amount": 5112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 6097.16, "estimated_amount": 6097, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 4559.54, "standard_charge_percentage": 39.6000, "estimated_amount": 4559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 10938.3, "standard_charge_percentage": 95.0000, "estimated_amount": 10938, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14905.8, "standard_charge_percentage": 78.5000, "estimated_amount": 14905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 6353.88, "estimated_amount": 6353, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15690.3, "standard_charge_percentage": 78.5000, "estimated_amount": 15690, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16989.5, "standard_charge_percentage": 85.0000, "estimated_amount": 16989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14990.8, "standard_charge_percentage": 75.0000, "estimated_amount": 14990, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19588, "standard_charge_percentage": 98.0000, "estimated_amount": 19587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 8767.34, "standard_charge_percentage": 78.5000, "estimated_amount": 8767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 8767.34, "standard_charge_percentage": 78.5000, "estimated_amount": 8767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18988.3, "standard_charge_percentage": 95.0000, "estimated_amount": 18988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 10938.3, "standard_charge_percentage": 95.0000, "estimated_amount": 10938, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 6482.24, "estimated_amount": 6482, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 6482.24, "estimated_amount": 6482, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19987.7, "standard_charge_percentage": 100.0000, "estimated_amount": 19987, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 5757, "standard_charge_percentage": 50.0000, "estimated_amount": 5757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 6332.7, "standard_charge_percentage": 55.0000, "estimated_amount": 6332, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15533.4, "standard_charge_percentage": 78.5000, "estimated_amount": 15533, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 8767.34, "standard_charge_percentage": 78.5000, "estimated_amount": 8767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 8635.5, "standard_charge_percentage": 75.0000, "estimated_amount": 8635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 9038.49, "standard_charge_percentage": 78.5000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 9786.9, "standard_charge_percentage": 85.0000, "estimated_amount": 9786, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 8315.41, "standard_charge_percentage": 78.5000, "estimated_amount": 8315, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14435.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8985.28, "estimated_amount": 8985, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 12836.1, "estimated_amount": 12836, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 11283.7, "standard_charge_percentage": 98.0000, "estimated_amount": 11283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 10074.8, "standard_charge_percentage": 87.5000, "estimated_amount": 10074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3454.2, "standard_charge_percentage": 30.0000, "estimated_amount": 3454, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15990.2, "standard_charge_percentage": 80.0000, "estimated_amount": 15990, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 10362.6, "standard_charge_percentage": 90.0000, "estimated_amount": 10362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9993.85, "standard_charge_percentage": 50.0000, "estimated_amount": 9993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 10362.6, "standard_charge_percentage": 90.0000, "estimated_amount": 10362, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9993.85, "standard_charge_percentage": 50.0000, "estimated_amount": 9993, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17988.9, "standard_charge_percentage": 90.0000, "estimated_amount": 17988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 10362.6, "standard_charge_percentage": 90.0000, "estimated_amount": 10362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8985.28, "estimated_amount": 8985, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 15219.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15219, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 6097.16, "estimated_amount": 6097, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9993.85, "standard_charge_percentage": 50.0000, "estimated_amount": 9993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 8767.34, "standard_charge_percentage": 78.5000, "estimated_amount": 8767, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 15219.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 8948.11, "standard_charge_percentage": 78.5000, "estimated_amount": 8948, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 9211.2, "standard_charge_percentage": 80.0000, "estimated_amount": 9211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 9038.49, "standard_charge_percentage": 78.5000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17988.9, "standard_charge_percentage": 90.0000, "estimated_amount": 17988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 15219.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15219, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 6546.42, "estimated_amount": 6546, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17489.2, "standard_charge_percentage": 87.5000, "estimated_amount": 17489, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 15219.6, "standard_charge_percentage": 78.5000, "estimated_amount": 15219, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Perq Vertebral Augmentation, Lumbar", "code_information": [ { "code": "22514", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 11801.7, "discounted_cash": 8343,"minimum": 286.51,"maximum": 19673.3,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 11211.6, "standard_charge_percentage": 95.0000, "estimated_amount": 11211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 8986.4, "standard_charge_percentage": 78.5000, "estimated_amount": 8986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 13899.2, "standard_charge_percentage": 78.5000, "estimated_amount": 13899, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 11801.7, "estimated_amount": 11801, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 6482.24, "estimated_amount": 6482, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 15443.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 6546.42, "estimated_amount": 6546, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9264.33, "standard_charge_percentage": 78.5000, "estimated_amount": 9264, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 5900.85, "standard_charge_percentage": 50.0000, "estimated_amount": 5900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 17706, "standard_charge_percentage": 90.0000, "estimated_amount": 17705, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 14208.1, "standard_charge_percentage": 78.5000, "estimated_amount": 14208, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 9836.65, "standard_charge_percentage": 50.0000, "estimated_amount": 9836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 17706, "standard_charge_percentage": 90.0000, "estimated_amount": 17705, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 10326.5, "standard_charge_percentage": 87.5000, "estimated_amount": 10326, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 5936.16, "estimated_amount": 5936, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 15289.1, "standard_charge_percentage": 78.5000, "estimated_amount": 15289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 7081.02, "standard_charge_percentage": 60.0000, "estimated_amount": 7081, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 14755, "standard_charge_percentage": 75.0000, "estimated_amount": 14754, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 10621.5, "standard_charge_percentage": 90.0000, "estimated_amount": 10621, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 12836.1, "estimated_amount": 12836, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 6353.88, "estimated_amount": 6353, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 5900.85, "standard_charge_percentage": 50.0000, "estimated_amount": 5900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 6490.94, "standard_charge_percentage": 55.0000, "estimated_amount": 6490, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 7790.63, "standard_charge_percentage": 39.6000, "estimated_amount": 7790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 8851.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8851, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 11565.7, "standard_charge_percentage": 98.0000, "estimated_amount": 11565, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 14980.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 15443.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 6482.24, "estimated_amount": 6482, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 17214.1, "standard_charge_percentage": 87.5000, "estimated_amount": 17214, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 9264.33, "standard_charge_percentage": 78.5000, "estimated_amount": 9264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 5239.95, "standard_charge_percentage": 44.4000, "estimated_amount": 5239, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 4673.47, "standard_charge_percentage": 39.6000, "estimated_amount": 4673, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 6097.16, "estimated_amount": 6097, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 8801.12, "standard_charge_percentage": 78.5000, "estimated_amount": 8801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3540.51, "standard_charge_percentage": 30.0000, "estimated_amount": 3540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 16722.3, "standard_charge_percentage": 85.0000, "estimated_amount": 16722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 8986.4, "standard_charge_percentage": 78.5000, "estimated_amount": 8986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 10031.5, "standard_charge_percentage": 85.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5901.99, "standard_charge_percentage": 30.0000, "estimated_amount": 5901, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 8986.4, "standard_charge_percentage": 78.5000, "estimated_amount": 8986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 14980.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 18689.6, "standard_charge_percentage": 95.0000, "estimated_amount": 18689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 6546.42, "estimated_amount": 6546, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 10031.5, "standard_charge_percentage": 85.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 14671.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 14980.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14980, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 17706, "standard_charge_percentage": 90.0000, "estimated_amount": 17705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 11801.7, "standard_charge_percentage": 100.0000, "estimated_amount": 11801, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 19279.8, "standard_charge_percentage": 98.0000, "estimated_amount": 19279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 14980.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8985.28, "estimated_amount": 8985, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 14980.2, "standard_charge_percentage": 78.5000, "estimated_amount": 14980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5900.85, "standard_charge_percentage": 50.0000, "estimated_amount": 5900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 8337.9, "standard_charge_percentage": 78.5000, "estimated_amount": 8337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8985.28, "estimated_amount": 8985, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 10820.3, "standard_charge_percentage": 55.0000, "estimated_amount": 10820, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 6097.16, "estimated_amount": 6097, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 10621.5, "standard_charge_percentage": 90.0000, "estimated_amount": 10621, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 286.51, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 10621.5, "standard_charge_percentage": 90.0000, "estimated_amount": 10621, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4619, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 11211.6, "standard_charge_percentage": 95.0000, "estimated_amount": 11211, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 18689.6, "standard_charge_percentage": 95.0000, "estimated_amount": 18689, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 8523.19, "standard_charge_percentage": 78.5000, "estimated_amount": 8523, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 14671.4, "standard_charge_percentage": 78.5000, "estimated_amount": 14671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 9836.65, "standard_charge_percentage": 50.0000, "estimated_amount": 9836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9947.99, "estimated_amount": 9947, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 19673.3, "standard_charge_percentage": 100.0000, "estimated_amount": 19673, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 9264.33, "standard_charge_percentage": 78.5000, "estimated_amount": 9264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 9441.36, "standard_charge_percentage": 80.0000, "estimated_amount": 9441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 9836.65, "standard_charge_percentage": 50.0000, "estimated_amount": 9836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 16722.3, "standard_charge_percentage": 85.0000, "estimated_amount": 16722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15738.6, "standard_charge_percentage": 80.0000, "estimated_amount": 15738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 8986.4, "standard_charge_percentage": 78.5000, "estimated_amount": 8986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 8801.12, "standard_charge_percentage": 78.5000, "estimated_amount": 8801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 8986.4, "standard_charge_percentage": 78.5000, "estimated_amount": 8986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15443.5, "standard_charge_percentage": 78.5000, "estimated_amount": 15443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 6418.06, "estimated_amount": 6418, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 9171.69, "standard_charge_percentage": 78.5000, "estimated_amount": 9171, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 6353.88, "estimated_amount": 6353, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Vertebral Augmentation Add, Thora Or Lumb", "code_information": [ { "code": "22515", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7300,"minimum": 511,"maximum": 7300,"payers_information":[{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3650, "standard_charge_percentage": 50.0000, "estimated_amount": 3650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5558.59, "standard_charge_percentage": 78.5000, "estimated_amount": 5558, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5272.06, "standard_charge_percentage": 78.5000, "estimated_amount": 5272, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5730.5, "standard_charge_percentage": 78.5000, "estimated_amount": 5730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3241.2, "standard_charge_percentage": 44.4000, "estimated_amount": 3241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5443.97, "standard_charge_percentage": 78.5000, "estimated_amount": 5443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5558.59, "standard_charge_percentage": 78.5000, "estimated_amount": 5558, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6935, "standard_charge_percentage": 95.0000, "estimated_amount": 6935, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 7154, "standard_charge_percentage": 98.0000, "estimated_amount": 7154, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5558.59, "standard_charge_percentage": 78.5000, "estimated_amount": 5558, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6570, "standard_charge_percentage": 90.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6205, "standard_charge_percentage": 85.0000, "estimated_amount": 6205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5558.59, "standard_charge_percentage": 78.5000, "estimated_amount": 5558, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5157.45, "standard_charge_percentage": 78.5000, "estimated_amount": 5157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4015, "standard_charge_percentage": 55.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6205, "standard_charge_percentage": 85.0000, "estimated_amount": 6205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5730.5, "standard_charge_percentage": 78.5000, "estimated_amount": 5730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 4380, "standard_charge_percentage": 60.0000, "estimated_amount": 4380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5730.5, "standard_charge_percentage": 78.5000, "estimated_amount": 5730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5443.97, "standard_charge_percentage": 78.5000, "estimated_amount": 5443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2190, "standard_charge_percentage": 30.0000, "estimated_amount": 2190, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3650, "standard_charge_percentage": 50.0000, "estimated_amount": 3650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6570, "standard_charge_percentage": 90.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3650, "standard_charge_percentage": 50.0000, "estimated_amount": 3650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6935, "standard_charge_percentage": 95.0000, "estimated_amount": 6935, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5673.19, "standard_charge_percentage": 78.5000, "estimated_amount": 5673, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7300, "standard_charge_percentage": 100.0000, "estimated_amount": 7300, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5475, "standard_charge_percentage": 75.0000, "estimated_amount": 5475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2890.8, "standard_charge_percentage": 39.6000, "estimated_amount": 2890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6570, "standard_charge_percentage": 90.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 7300, "estimated_amount": 7300, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6387.5, "standard_charge_percentage": 87.5000, "estimated_amount": 6387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5558.59, "standard_charge_percentage": 78.5000, "estimated_amount": 5558, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5840, "standard_charge_percentage": 80.0000, "estimated_amount": 5840, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22551", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6934.96, "discounted_cash": 15027,"minimum": 1502.16,"maximum": 6934.96,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5201.22, "standard_charge_percentage": 75.0000, "estimated_amount": 5201, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3814.23, "standard_charge_percentage": 55.0000, "estimated_amount": 3814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2080.49, "standard_charge_percentage": 30.0000, "estimated_amount": 2080, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5280.63, "standard_charge_percentage": 78.5000, "estimated_amount": 5280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2773.98, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5280.63, "standard_charge_percentage": 78.5000, "estimated_amount": 5280, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3467.48, "standard_charge_percentage": 50.0000, "estimated_amount": 3467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5280.63, "standard_charge_percentage": 78.5000, "estimated_amount": 5280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5171.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5171, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5389.5, "standard_charge_percentage": 78.5000, "estimated_amount": 5389, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3467.48, "standard_charge_percentage": 50.0000, "estimated_amount": 3467, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5443.94, "standard_charge_percentage": 78.5000, "estimated_amount": 5443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5443.94, "standard_charge_percentage": 78.5000, "estimated_amount": 5443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5443.94, "standard_charge_percentage": 78.5000, "estimated_amount": 5443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5894.72, "standard_charge_percentage": 85.0000, "estimated_amount": 5894, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6796.26, "standard_charge_percentage": 98.0000, "estimated_amount": 6796, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4899.55, "standard_charge_percentage": 78.5000, "estimated_amount": 4899, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5280.63, "standard_charge_percentage": 78.5000, "estimated_amount": 5280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1502.16, "estimated_amount": 1502, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5280.63, "standard_charge_percentage": 78.5000, "estimated_amount": 5280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6588.21, "standard_charge_percentage": 95.0000, "estimated_amount": 6588, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6241.46, "standard_charge_percentage": 90.0000, "estimated_amount": 6241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6241.46, "standard_charge_percentage": 90.0000, "estimated_amount": 6241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6934.96, "standard_charge_percentage": 100.0000, "estimated_amount": 6934, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1502.16, "estimated_amount": 1502, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6068.09, "standard_charge_percentage": 87.5000, "estimated_amount": 6068, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6588.21, "standard_charge_percentage": 95.0000, "estimated_amount": 6588, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6241.46, "standard_charge_percentage": 90.0000, "estimated_amount": 6241, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3467.48, "standard_charge_percentage": 50.0000, "estimated_amount": 3467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5894.72, "standard_charge_percentage": 85.0000, "estimated_amount": 5894, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5547.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5171.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5171, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5008.43, "standard_charge_percentage": 78.5000, "estimated_amount": 5008, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2746.24, "standard_charge_percentage": 39.6000, "estimated_amount": 2746, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6934.96, "estimated_amount": 6934, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22552", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6476.03,"minimum": 1942.81,"maximum": 6476.03,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5032.85, "standard_charge_percentage": 78.5000, "estimated_amount": 5032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5828.43, "standard_charge_percentage": 90.0000, "estimated_amount": 5828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5083.68, "standard_charge_percentage": 78.5000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3561.82, "standard_charge_percentage": 55.0000, "estimated_amount": 3561, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4829.5, "standard_charge_percentage": 78.5000, "estimated_amount": 4829, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4316, "estimated_amount": 4316, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2564.51, "standard_charge_percentage": 39.6000, "estimated_amount": 2564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4857.02, "standard_charge_percentage": 75.0000, "estimated_amount": 4857, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4676.99, "standard_charge_percentage": 78.5000, "estimated_amount": 4676, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5828.43, "standard_charge_percentage": 90.0000, "estimated_amount": 5828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5504.63, "standard_charge_percentage": 85.0000, "estimated_amount": 5504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4829.5, "standard_charge_percentage": 78.5000, "estimated_amount": 4829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3238.01, "standard_charge_percentage": 50.0000, "estimated_amount": 3238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4931.17, "standard_charge_percentage": 78.5000, "estimated_amount": 4931, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5504.63, "standard_charge_percentage": 85.0000, "estimated_amount": 5504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6476.03, "standard_charge_percentage": 100.0000, "estimated_amount": 6476, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4931.17, "standard_charge_percentage": 78.5000, "estimated_amount": 4931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3885.62, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4575.32, "standard_charge_percentage": 78.5000, "estimated_amount": 4575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6152.23, "standard_charge_percentage": 95.0000, "estimated_amount": 6152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3238.01, "standard_charge_percentage": 50.0000, "estimated_amount": 3238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4931.17, "standard_charge_percentage": 78.5000, "estimated_amount": 4931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2590.41, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5083.68, "standard_charge_percentage": 78.5000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3238.01, "standard_charge_percentage": 50.0000, "estimated_amount": 3238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5828.43, "standard_charge_percentage": 90.0000, "estimated_amount": 5828, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4931.17, "standard_charge_percentage": 78.5000, "estimated_amount": 4931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6152.23, "standard_charge_percentage": 95.0000, "estimated_amount": 6152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1942.81, "standard_charge_percentage": 30.0000, "estimated_amount": 1942, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 6476.03, "estimated_amount": 6476, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6346.51, "standard_charge_percentage": 98.0000, "estimated_amount": 6346, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5083.68, "standard_charge_percentage": 78.5000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5666.53, "standard_charge_percentage": 87.5000, "estimated_amount": 5666, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4931.17, "standard_charge_percentage": 78.5000, "estimated_amount": 4931, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5180.82, "standard_charge_percentage": 80.0000, "estimated_amount": 5180, "methodology": "percent of total billed charges" }]}]} , { "description": "NECK SPINE FUSION", "code_information": [ { "code": "22554", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8712.24, "discounted_cash": 15027,"minimum": 2613.67,"maximum": 8712.24,"payers_information":[{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6633.94, "standard_charge_percentage": 78.5000, "estimated_amount": 6633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 8276.63, "standard_charge_percentage": 95.0000, "estimated_amount": 8276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6633.94, "standard_charge_percentage": 78.5000, "estimated_amount": 6633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7405.4, "standard_charge_percentage": 85.0000, "estimated_amount": 7405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 7841.02, "standard_charge_percentage": 90.0000, "estimated_amount": 7841, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6155.2, "standard_charge_percentage": 78.5000, "estimated_amount": 6155, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 6839.11, "standard_charge_percentage": 78.5000, "estimated_amount": 6839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6497.15, "standard_charge_percentage": 78.5000, "estimated_amount": 6497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3450.05, "standard_charge_percentage": 39.6000, "estimated_amount": 3450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4356.12, "standard_charge_percentage": 50.0000, "estimated_amount": 4356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 7841.02, "standard_charge_percentage": 90.0000, "estimated_amount": 7841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 6839.11, "standard_charge_percentage": 78.5000, "estimated_amount": 6839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3484.9, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3484, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 8712.24, "standard_charge_percentage": 100.0000, "estimated_amount": 8712, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 7623.21, "standard_charge_percentage": 87.5000, "estimated_amount": 7623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6839.11, "standard_charge_percentage": 78.5000, "estimated_amount": 6839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6497.15, "standard_charge_percentage": 78.5000, "estimated_amount": 6497, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2613.67, "standard_charge_percentage": 30.0000, "estimated_amount": 2613, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 8538, "standard_charge_percentage": 98.0000, "estimated_amount": 8538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 6770.72, "standard_charge_percentage": 78.5000, "estimated_amount": 6770, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6291.98, "standard_charge_percentage": 78.5000, "estimated_amount": 6291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7405.4, "standard_charge_percentage": 85.0000, "estimated_amount": 7405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 8276.63, "standard_charge_percentage": 95.0000, "estimated_amount": 8276, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 7841.02, "standard_charge_percentage": 90.0000, "estimated_amount": 7841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6633.94, "standard_charge_percentage": 78.5000, "estimated_amount": 6633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6633.94, "standard_charge_percentage": 78.5000, "estimated_amount": 6633, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4356.12, "standard_charge_percentage": 50.0000, "estimated_amount": 4356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 8712.24, "estimated_amount": 8712, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6534.18, "standard_charge_percentage": 75.0000, "estimated_amount": 6534, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4356.12, "standard_charge_percentage": 50.0000, "estimated_amount": 4356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 6969.79, "standard_charge_percentage": 80.0000, "estimated_amount": 6969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4791.73, "standard_charge_percentage": 55.0000, "estimated_amount": 4791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6633.94, "standard_charge_percentage": 78.5000, "estimated_amount": 6633, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22558", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7289.96,"minimum": 2186.99,"maximum": 7289.96,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 7144.16, "standard_charge_percentage": 98.0000, "estimated_amount": 7144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3644.98, "standard_charge_percentage": 50.0000, "estimated_amount": 3644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2915.98, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5722.62, "standard_charge_percentage": 78.5000, "estimated_amount": 5722, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5550.94, "standard_charge_percentage": 78.5000, "estimated_amount": 5550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5550.94, "standard_charge_percentage": 78.5000, "estimated_amount": 5550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5722.62, "standard_charge_percentage": 78.5000, "estimated_amount": 5722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5665.39, "standard_charge_percentage": 78.5000, "estimated_amount": 5665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6560.96, "standard_charge_percentage": 90.0000, "estimated_amount": 6560, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6196.47, "standard_charge_percentage": 85.0000, "estimated_amount": 6196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5436.49, "standard_charge_percentage": 78.5000, "estimated_amount": 5436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5550.94, "standard_charge_percentage": 78.5000, "estimated_amount": 5550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6925.46, "standard_charge_percentage": 95.0000, "estimated_amount": 6925, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6560.96, "standard_charge_percentage": 90.0000, "estimated_amount": 6560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7289.96, "standard_charge_percentage": 100.0000, "estimated_amount": 7289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5150.36, "standard_charge_percentage": 78.5000, "estimated_amount": 5150, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 7289.96, "estimated_amount": 7289, "methodology": "fee schedule" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3644.98, "standard_charge_percentage": 50.0000, "estimated_amount": 3644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5467.47, "standard_charge_percentage": 75.0000, "estimated_amount": 5467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2186.99, "standard_charge_percentage": 30.0000, "estimated_amount": 2186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5722.62, "standard_charge_percentage": 78.5000, "estimated_amount": 5722, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 6587, "estimated_amount": 6587, "methodology": "case rate" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2886.82, "standard_charge_percentage": 39.6000, "estimated_amount": 2886, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5264.81, "standard_charge_percentage": 78.5000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5550.94, "standard_charge_percentage": 78.5000, "estimated_amount": 5550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5831.97, "standard_charge_percentage": 80.0000, "estimated_amount": 5831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5436.49, "standard_charge_percentage": 78.5000, "estimated_amount": 5436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6560.96, "standard_charge_percentage": 90.0000, "estimated_amount": 6560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6925.46, "standard_charge_percentage": 95.0000, "estimated_amount": 6925, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3644.98, "standard_charge_percentage": 50.0000, "estimated_amount": 3644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5550.94, "standard_charge_percentage": 78.5000, "estimated_amount": 5550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6196.47, "standard_charge_percentage": 85.0000, "estimated_amount": 6196, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6378.72, "standard_charge_percentage": 87.5000, "estimated_amount": 6378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4009.48, "standard_charge_percentage": 55.0000, "estimated_amount": 4009, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22585", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6035.33,"minimum": 1810.6,"maximum": 6035.33,"payers_information":[{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2389.99, "standard_charge_percentage": 39.6000, "estimated_amount": 2389, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3017.66, "standard_charge_percentage": 50.0000, "estimated_amount": 3017, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4500.85, "standard_charge_percentage": 78.5000, "estimated_amount": 4500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3621.2, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3621, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4690.36, "standard_charge_percentage": 78.5000, "estimated_amount": 4690, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4358.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4358, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5431.8, "standard_charge_percentage": 90.0000, "estimated_amount": 5431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4526.5, "standard_charge_percentage": 75.0000, "estimated_amount": 4526, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5130.03, "standard_charge_percentage": 85.0000, "estimated_amount": 5130, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4595.6, "standard_charge_percentage": 78.5000, "estimated_amount": 4595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5733.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4595.6, "standard_charge_percentage": 78.5000, "estimated_amount": 4595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6035.33, "standard_charge_percentage": 100.0000, "estimated_amount": 6035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1810.6, "standard_charge_percentage": 30.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5733.56, "standard_charge_percentage": 95.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3319.43, "standard_charge_percentage": 55.0000, "estimated_amount": 3319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4737.73, "standard_charge_percentage": 78.5000, "estimated_amount": 4737, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 6035.33, "estimated_amount": 6035, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4263.96, "standard_charge_percentage": 78.5000, "estimated_amount": 4263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4595.6, "standard_charge_percentage": 78.5000, "estimated_amount": 4595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5431.8, "standard_charge_percentage": 90.0000, "estimated_amount": 5431, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3017.66, "standard_charge_percentage": 50.0000, "estimated_amount": 3017, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5431.8, "standard_charge_percentage": 90.0000, "estimated_amount": 5431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4500.85, "standard_charge_percentage": 78.5000, "estimated_amount": 4500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4595.6, "standard_charge_percentage": 78.5000, "estimated_amount": 4595, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4595.6, "standard_charge_percentage": 78.5000, "estimated_amount": 4595, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5914.62, "standard_charge_percentage": 98.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4828.26, "standard_charge_percentage": 80.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2414.13, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2414, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3017.66, "standard_charge_percentage": 50.0000, "estimated_amount": 3017, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5280.91, "standard_charge_percentage": 87.5000, "estimated_amount": 5280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4737.73, "standard_charge_percentage": 78.5000, "estimated_amount": 4737, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5130.03, "standard_charge_percentage": 85.0000, "estimated_amount": 5130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4737.73, "standard_charge_percentage": 78.5000, "estimated_amount": 4737, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22612", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9089.54, "discounted_cash": 21478,"minimum": 2726.86,"maximum": 9089.54,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6778.52, "standard_charge_percentage": 78.5000, "estimated_amount": 6778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 7953.35, "standard_charge_percentage": 87.5000, "estimated_amount": 7953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7135.29, "standard_charge_percentage": 78.5000, "estimated_amount": 7135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6921.23, "standard_charge_percentage": 78.5000, "estimated_amount": 6921, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8180.59, "standard_charge_percentage": 90.0000, "estimated_amount": 8180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6921.23, "standard_charge_percentage": 78.5000, "estimated_amount": 6921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7726.11, "standard_charge_percentage": 85.0000, "estimated_amount": 7726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8180.59, "standard_charge_percentage": 90.0000, "estimated_amount": 8180, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3599.46, "standard_charge_percentage": 39.6000, "estimated_amount": 3599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3635.82, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 8907.75, "standard_charge_percentage": 98.0000, "estimated_amount": 8907, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7063.94, "standard_charge_percentage": 78.5000, "estimated_amount": 7063, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6921.23, "standard_charge_percentage": 78.5000, "estimated_amount": 6921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7135.29, "standard_charge_percentage": 78.5000, "estimated_amount": 7135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4544.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4544, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 8635.06, "standard_charge_percentage": 95.0000, "estimated_amount": 8635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8180.59, "standard_charge_percentage": 90.0000, "estimated_amount": 8180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9089.54, "standard_charge_percentage": 100.0000, "estimated_amount": 9089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6921.23, "standard_charge_percentage": 78.5000, "estimated_amount": 6921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4999.25, "standard_charge_percentage": 55.0000, "estimated_amount": 4999, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4544.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6778.52, "standard_charge_percentage": 78.5000, "estimated_amount": 6778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 8635.06, "standard_charge_percentage": 95.0000, "estimated_amount": 8635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6421.76, "standard_charge_percentage": 78.5000, "estimated_amount": 6421, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6564.47, "standard_charge_percentage": 78.5000, "estimated_amount": 6564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6817.16, "standard_charge_percentage": 75.0000, "estimated_amount": 6817, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7726.11, "standard_charge_percentage": 85.0000, "estimated_amount": 7726, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4544.77, "standard_charge_percentage": 50.0000, "estimated_amount": 4544, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2726.86, "standard_charge_percentage": 30.0000, "estimated_amount": 2726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6921.23, "standard_charge_percentage": 78.5000, "estimated_amount": 6921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7271.63, "standard_charge_percentage": 80.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7135.29, "standard_charge_percentage": 78.5000, "estimated_amount": 7135, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 9089.54, "estimated_amount": 9089, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22614", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7486.8,"minimum": 511,"maximum": 7486.8,"payers_information":[{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 7112.46, "standard_charge_percentage": 95.0000, "estimated_amount": 7112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5877.14, "standard_charge_percentage": 78.5000, "estimated_amount": 5877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3743.4, "standard_charge_percentage": 50.0000, "estimated_amount": 3743, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5700.82, "standard_charge_percentage": 78.5000, "estimated_amount": 5700, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3743.4, "standard_charge_percentage": 50.0000, "estimated_amount": 3743, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6550.95, "standard_charge_percentage": 87.5000, "estimated_amount": 6550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5877.14, "standard_charge_percentage": 78.5000, "estimated_amount": 5877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6738.12, "standard_charge_percentage": 90.0000, "estimated_amount": 6738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5700.82, "standard_charge_percentage": 78.5000, "estimated_amount": 5700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2246.04, "standard_charge_percentage": 30.0000, "estimated_amount": 2246, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5615.1, "standard_charge_percentage": 75.0000, "estimated_amount": 5615, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6738.12, "standard_charge_percentage": 90.0000, "estimated_amount": 6738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2994.72, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 7486.8, "estimated_amount": 7486, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5583.28, "standard_charge_percentage": 78.5000, "estimated_amount": 5583, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5406.97, "standard_charge_percentage": 78.5000, "estimated_amount": 5406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 7337.06, "standard_charge_percentage": 98.0000, "estimated_amount": 7337, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3743.4, "standard_charge_percentage": 50.0000, "estimated_amount": 3743, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6363.78, "standard_charge_percentage": 85.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5877.14, "standard_charge_percentage": 78.5000, "estimated_amount": 5877, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7486.8, "standard_charge_percentage": 100.0000, "estimated_amount": 7486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2964.77, "standard_charge_percentage": 39.6000, "estimated_amount": 2964, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5700.82, "standard_charge_percentage": 78.5000, "estimated_amount": 5700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5700.82, "standard_charge_percentage": 78.5000, "estimated_amount": 5700, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6738.12, "standard_charge_percentage": 90.0000, "estimated_amount": 6738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4117.74, "standard_charge_percentage": 55.0000, "estimated_amount": 4117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5583.28, "standard_charge_percentage": 78.5000, "estimated_amount": 5583, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5989.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5989, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5818.37, "standard_charge_percentage": 78.5000, "estimated_amount": 5818, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6363.78, "standard_charge_percentage": 85.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 7112.46, "standard_charge_percentage": 95.0000, "estimated_amount": 7112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5289.42, "standard_charge_percentage": 78.5000, "estimated_amount": 5289, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5700.82, "standard_charge_percentage": 78.5000, "estimated_amount": 5700, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22630", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8288.22, "discounted_cash": 21478,"minimum": 2486.47,"maximum": 8288.22,"payers_information":[{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6311.07, "standard_charge_percentage": 78.5000, "estimated_amount": 6311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2486.47, "standard_charge_percentage": 30.0000, "estimated_amount": 2486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5855.63, "standard_charge_percentage": 78.5000, "estimated_amount": 5855, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 6587, "estimated_amount": 6587, "methodology": "case rate" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6311.07, "standard_charge_percentage": 78.5000, "estimated_amount": 6311, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4144.11, "standard_charge_percentage": 50.0000, "estimated_amount": 4144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 7252.19, "standard_charge_percentage": 87.5000, "estimated_amount": 7252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6311.07, "standard_charge_percentage": 78.5000, "estimated_amount": 6311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6180.94, "standard_charge_percentage": 78.5000, "estimated_amount": 6180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 8288.22, "standard_charge_percentage": 100.0000, "estimated_amount": 8288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 7873.81, "standard_charge_percentage": 95.0000, "estimated_amount": 7873, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 7873.81, "standard_charge_percentage": 95.0000, "estimated_amount": 7873, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3315.29, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6216.16, "standard_charge_percentage": 75.0000, "estimated_amount": 6216, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5985.75, "standard_charge_percentage": 78.5000, "estimated_amount": 5985, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4558.52, "standard_charge_percentage": 55.0000, "estimated_amount": 4558, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7044.99, "standard_charge_percentage": 85.0000, "estimated_amount": 7044, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4144.11, "standard_charge_percentage": 50.0000, "estimated_amount": 4144, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6180.94, "standard_charge_percentage": 78.5000, "estimated_amount": 6180, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 7459.4, "standard_charge_percentage": 90.0000, "estimated_amount": 7459, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6311.07, "standard_charge_percentage": 78.5000, "estimated_amount": 6311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 6441.19, "standard_charge_percentage": 78.5000, "estimated_amount": 6441, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 8122.46, "standard_charge_percentage": 98.0000, "estimated_amount": 8122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6506.25, "standard_charge_percentage": 78.5000, "estimated_amount": 6506, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3282.14, "standard_charge_percentage": 39.6000, "estimated_amount": 3282, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 6506.25, "standard_charge_percentage": 78.5000, "estimated_amount": 6506, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 6630.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 7459.4, "standard_charge_percentage": 90.0000, "estimated_amount": 7459, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 7459.4, "standard_charge_percentage": 90.0000, "estimated_amount": 7459, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4144.11, "standard_charge_percentage": 50.0000, "estimated_amount": 4144, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6311.07, "standard_charge_percentage": 78.5000, "estimated_amount": 6311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 6506.25, "standard_charge_percentage": 78.5000, "estimated_amount": 6506, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7044.99, "standard_charge_percentage": 85.0000, "estimated_amount": 7044, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 8288.22, "estimated_amount": 8288, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22632", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7166.96,"minimum": 511,"maximum": 7166.96,"payers_information":[{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 7023.62, "standard_charge_percentage": 98.0000, "estimated_amount": 7023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5375.22, "standard_charge_percentage": 75.0000, "estimated_amount": 5375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5569.8, "standard_charge_percentage": 78.5000, "estimated_amount": 5569, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5626.06, "standard_charge_percentage": 78.5000, "estimated_amount": 5626, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5175.98, "standard_charge_percentage": 78.5000, "estimated_amount": 5175, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5063.46, "standard_charge_percentage": 78.5000, "estimated_amount": 5063, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6450.26, "standard_charge_percentage": 90.0000, "estimated_amount": 6450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6271.09, "standard_charge_percentage": 87.5000, "estimated_amount": 6271, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6091.92, "standard_charge_percentage": 85.0000, "estimated_amount": 6091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2150.09, "standard_charge_percentage": 30.0000, "estimated_amount": 2150, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5457.28, "standard_charge_percentage": 78.5000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3583.48, "standard_charge_percentage": 50.0000, "estimated_amount": 3583, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 7166.96, "estimated_amount": 7166, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5626.06, "standard_charge_percentage": 78.5000, "estimated_amount": 5626, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6808.61, "standard_charge_percentage": 95.0000, "estimated_amount": 6808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5457.28, "standard_charge_percentage": 78.5000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2866.78, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2866, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6808.61, "standard_charge_percentage": 95.0000, "estimated_amount": 6808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5344.76, "standard_charge_percentage": 78.5000, "estimated_amount": 5344, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3583.48, "standard_charge_percentage": 50.0000, "estimated_amount": 3583, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5457.28, "standard_charge_percentage": 78.5000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6450.26, "standard_charge_percentage": 90.0000, "estimated_amount": 6450, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7166.96, "standard_charge_percentage": 100.0000, "estimated_amount": 7166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3583.48, "standard_charge_percentage": 50.0000, "estimated_amount": 3583, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2838.12, "standard_charge_percentage": 39.6000, "estimated_amount": 2838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5344.76, "standard_charge_percentage": 78.5000, "estimated_amount": 5344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3941.83, "standard_charge_percentage": 55.0000, "estimated_amount": 3941, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5733.57, "standard_charge_percentage": 80.0000, "estimated_amount": 5733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5457.28, "standard_charge_percentage": 78.5000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6091.92, "standard_charge_percentage": 85.0000, "estimated_amount": 6091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5626.06, "standard_charge_percentage": 78.5000, "estimated_amount": 5626, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5457.28, "standard_charge_percentage": 78.5000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6450.26, "standard_charge_percentage": 90.0000, "estimated_amount": 6450, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22633", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 11537, "discounted_cash": 21478,"minimum": 3461.11,"maximum": 11537,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9056.56, "standard_charge_percentage": 78.5000, "estimated_amount": 9056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 8966, "standard_charge_percentage": 78.5000, "estimated_amount": 8966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 4614.81, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 4614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "NaphCare Prison", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 5768.51, "standard_charge_percentage": 50.0000, "estimated_amount": 5768, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Service Center", "plan_name": "Health Service Center Medicare - OP Only", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 8603.73, "standard_charge_percentage": 78.5000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Medicare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Veterans Choice", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 11537, "standard_charge_percentage": 100.0000, "estimated_amount": 11537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Medicare (07-09-2025 - 12-31-2025)", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Commercial", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 8332.04, "standard_charge_percentage": 78.5000, "estimated_amount": 8332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 9056.56, "standard_charge_percentage": 78.5000, "estimated_amount": 9056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 10960.2, "standard_charge_percentage": 95.0000, "estimated_amount": 10960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 7950, "estimated_amount": 7950, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 8603.73, "standard_charge_percentage": 78.5000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 8784.86, "standard_charge_percentage": 78.5000, "estimated_amount": 8784, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3461.11, "standard_charge_percentage": 30.0000, "estimated_amount": 3461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 8784.86, "standard_charge_percentage": 78.5000, "estimated_amount": 8784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 10094.9, "standard_charge_percentage": 87.5000, "estimated_amount": 10094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 8784.86, "standard_charge_percentage": 78.5000, "estimated_amount": 8784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 8150.9, "standard_charge_percentage": 78.5000, "estimated_amount": 8150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Humana", "plan_name": "Humana Tricare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 9806.47, "standard_charge_percentage": 85.0000, "estimated_amount": 9806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare Medicare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 10383.3, "standard_charge_percentage": 90.0000, "estimated_amount": 10383, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5768.51, "standard_charge_percentage": 50.0000, "estimated_amount": 5768, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 6345.36, "standard_charge_percentage": 55.0000, "estimated_amount": 6345, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH MEDICARE ADVANTAGE", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 4568.66, "standard_charge_percentage": 39.6000, "estimated_amount": 4568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare HMO & PPO - True Choice", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 5768.51, "standard_charge_percentage": 50.0000, "estimated_amount": 5768, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Medicare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 9056.56, "standard_charge_percentage": 78.5000, "estimated_amount": 9056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Devoted Health", "plan_name": "Devoted Health Medicare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Naphcare", "plan_name": "Naphcare Residential Treatment Centers - Prison", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Health Spring Medicare PPO", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 10383.3, "standard_charge_percentage": 90.0000, "estimated_amount": 10383, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 10383.3, "standard_charge_percentage": 90.0000, "estimated_amount": 10383, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 10960.2, "standard_charge_percentage": 95.0000, "estimated_amount": 10960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 11306.3, "standard_charge_percentage": 98.0000, "estimated_amount": 11306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 8784.86, "standard_charge_percentage": 78.5000, "estimated_amount": 8784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 9806.47, "standard_charge_percentage": 85.0000, "estimated_amount": 9806, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select Plus", "standard_charge_dollar": 11537, "estimated_amount": 11537, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 8784.86, "standard_charge_percentage": 78.5000, "estimated_amount": 8784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 8652.76, "standard_charge_percentage": 75.0000, "estimated_amount": 8652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 9229.62, "standard_charge_percentage": 80.0000, "estimated_amount": 9229, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22634", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9538.38,"minimum": 511,"maximum": 9538.38,"payers_information":[{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3815.35, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8346.08, "standard_charge_percentage": 87.5000, "estimated_amount": 8346, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7412.75, "standard_charge_percentage": 78.5000, "estimated_amount": 7412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4769.19, "standard_charge_percentage": 50.0000, "estimated_amount": 4769, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3777.2, "standard_charge_percentage": 39.6000, "estimated_amount": 3777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2861.51, "standard_charge_percentage": 30.0000, "estimated_amount": 2861, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4769.19, "standard_charge_percentage": 50.0000, "estimated_amount": 4769, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4769.19, "standard_charge_percentage": 50.0000, "estimated_amount": 4769, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 7113.25, "standard_charge_percentage": 78.5000, "estimated_amount": 7113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 7263, "standard_charge_percentage": 78.5000, "estimated_amount": 7263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5246.11, "standard_charge_percentage": 55.0000, "estimated_amount": 5246, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 7153.78, "standard_charge_percentage": 75.0000, "estimated_amount": 7153, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 9538.38, "estimated_amount": 9538, "methodology": "fee schedule" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 9347.61, "standard_charge_percentage": 98.0000, "estimated_amount": 9347, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 8107.62, "standard_charge_percentage": 85.0000, "estimated_amount": 8107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 8107.62, "standard_charge_percentage": 85.0000, "estimated_amount": 8107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7487.63, "standard_charge_percentage": 78.5000, "estimated_amount": 7487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 7263, "standard_charge_percentage": 78.5000, "estimated_amount": 7263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7487.63, "standard_charge_percentage": 78.5000, "estimated_amount": 7487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8584.54, "standard_charge_percentage": 90.0000, "estimated_amount": 8584, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 7263, "standard_charge_percentage": 78.5000, "estimated_amount": 7263, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 7263, "standard_charge_percentage": 78.5000, "estimated_amount": 7263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8584.54, "standard_charge_percentage": 90.0000, "estimated_amount": 8584, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 7263, "standard_charge_percentage": 78.5000, "estimated_amount": 7263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8584.54, "standard_charge_percentage": 90.0000, "estimated_amount": 8584, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 9061.46, "standard_charge_percentage": 95.0000, "estimated_amount": 9061, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9538.38, "standard_charge_percentage": 100.0000, "estimated_amount": 9538, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7630.7, "standard_charge_percentage": 80.0000, "estimated_amount": 7630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6738.87, "standard_charge_percentage": 78.5000, "estimated_amount": 6738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 7113.25, "standard_charge_percentage": 78.5000, "estimated_amount": 7113, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 9061.46, "standard_charge_percentage": 95.0000, "estimated_amount": 9061, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7487.63, "standard_charge_percentage": 78.5000, "estimated_amount": 7487, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6888.62, "standard_charge_percentage": 78.5000, "estimated_amount": 6888, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22840", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9145.75,"minimum": 511,"maximum": 9145.75,"payers_information":[{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6964.03, "standard_charge_percentage": 78.5000, "estimated_amount": 6964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 9145.75, "standard_charge_percentage": 100.0000, "estimated_amount": 9145, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 9145.75, "estimated_amount": 9145, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4572.88, "standard_charge_percentage": 50.0000, "estimated_amount": 4572, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 6605.06, "standard_charge_percentage": 78.5000, "estimated_amount": 6605, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 7179.41, "standard_charge_percentage": 78.5000, "estimated_amount": 7179, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4572.88, "standard_charge_percentage": 50.0000, "estimated_amount": 4572, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7179.41, "standard_charge_percentage": 78.5000, "estimated_amount": 7179, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 8962.83, "standard_charge_percentage": 98.0000, "estimated_amount": 8962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 8231.17, "standard_charge_percentage": 90.0000, "estimated_amount": 8231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6859.31, "standard_charge_percentage": 75.0000, "estimated_amount": 6859, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 8231.17, "standard_charge_percentage": 90.0000, "estimated_amount": 8231, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4572.88, "standard_charge_percentage": 50.0000, "estimated_amount": 4572, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3658.3, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6964.03, "standard_charge_percentage": 78.5000, "estimated_amount": 6964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3621.72, "standard_charge_percentage": 39.6000, "estimated_amount": 3621, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 6820.44, "standard_charge_percentage": 78.5000, "estimated_amount": 6820, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 7773.89, "standard_charge_percentage": 85.0000, "estimated_amount": 7773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 6820.44, "standard_charge_percentage": 78.5000, "estimated_amount": 6820, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 8231.17, "standard_charge_percentage": 90.0000, "estimated_amount": 8231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6964.03, "standard_charge_percentage": 78.5000, "estimated_amount": 6964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2743.72, "standard_charge_percentage": 30.0000, "estimated_amount": 2743, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 8688.46, "standard_charge_percentage": 95.0000, "estimated_amount": 8688, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6964.03, "standard_charge_percentage": 78.5000, "estimated_amount": 6964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6964.03, "standard_charge_percentage": 78.5000, "estimated_amount": 6964, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 7179.41, "standard_charge_percentage": 78.5000, "estimated_amount": 7179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 8002.53, "standard_charge_percentage": 87.5000, "estimated_amount": 8002, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 6461.47, "standard_charge_percentage": 78.5000, "estimated_amount": 6461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 7107.62, "standard_charge_percentage": 78.5000, "estimated_amount": 7107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 8688.46, "standard_charge_percentage": 95.0000, "estimated_amount": 8688, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 7773.89, "standard_charge_percentage": 85.0000, "estimated_amount": 7773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 7316.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 5030.16, "standard_charge_percentage": 55.0000, "estimated_amount": 5030, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22842", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8040.77,"minimum": 511,"maximum": 8040.77,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 7236.69, "standard_charge_percentage": 90.0000, "estimated_amount": 7236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 6122.64, "standard_charge_percentage": 78.5000, "estimated_amount": 6122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 6122.64, "standard_charge_percentage": 78.5000, "estimated_amount": 6122, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5807.04, "standard_charge_percentage": 78.5000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 7236.69, "standard_charge_percentage": 90.0000, "estimated_amount": 7236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 7638.73, "standard_charge_percentage": 95.0000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 7035.67, "standard_charge_percentage": 87.5000, "estimated_amount": 7035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 4020.39, "standard_charge_percentage": 50.0000, "estimated_amount": 4020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 6312, "standard_charge_percentage": 78.5000, "estimated_amount": 6312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5996.4, "standard_charge_percentage": 78.5000, "estimated_amount": 5996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 3216.31, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 3216, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 8040.77, "estimated_amount": 8040, "methodology": "fee schedule" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 6122.64, "standard_charge_percentage": 78.5000, "estimated_amount": 6122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 5680.8, "standard_charge_percentage": 78.5000, "estimated_amount": 5680, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 7638.73, "standard_charge_percentage": 95.0000, "estimated_amount": 7638, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 6030.58, "standard_charge_percentage": 75.0000, "estimated_amount": 6030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 6834.65, "standard_charge_percentage": 85.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4020.39, "standard_charge_percentage": 50.0000, "estimated_amount": 4020, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 7879.95, "standard_charge_percentage": 98.0000, "estimated_amount": 7879, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 3184.14, "standard_charge_percentage": 39.6000, "estimated_amount": 3184, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5996.4, "standard_charge_percentage": 78.5000, "estimated_amount": 5996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 4422.42, "standard_charge_percentage": 55.0000, "estimated_amount": 4422, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 8040.77, "standard_charge_percentage": 100.0000, "estimated_amount": 8040, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 6248.88, "standard_charge_percentage": 78.5000, "estimated_amount": 6248, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 4020.39, "standard_charge_percentage": 50.0000, "estimated_amount": 4020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2412.23, "standard_charge_percentage": 30.0000, "estimated_amount": 2412, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6312, "standard_charge_percentage": 78.5000, "estimated_amount": 6312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 6432.62, "standard_charge_percentage": 80.0000, "estimated_amount": 6432, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 6122.64, "standard_charge_percentage": 78.5000, "estimated_amount": 6122, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 6834.65, "standard_charge_percentage": 85.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 6122.64, "standard_charge_percentage": 78.5000, "estimated_amount": 6122, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 6312, "standard_charge_percentage": 78.5000, "estimated_amount": 6312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 7236.69, "standard_charge_percentage": 90.0000, "estimated_amount": 7236, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22845", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6354.75,"minimum": 1056,"maximum": 6354.75,"payers_information":[{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4988.48, "standard_charge_percentage": 78.5000, "estimated_amount": 4988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4938.59, "standard_charge_percentage": 78.5000, "estimated_amount": 4938, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5719.27, "standard_charge_percentage": 90.0000, "estimated_amount": 5719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5719.27, "standard_charge_percentage": 90.0000, "estimated_amount": 5719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4988.48, "standard_charge_percentage": 78.5000, "estimated_amount": 4988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4838.82, "standard_charge_percentage": 78.5000, "estimated_amount": 4838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3812.85, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5719.27, "standard_charge_percentage": 90.0000, "estimated_amount": 5719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5401.54, "standard_charge_percentage": 85.0000, "estimated_amount": 5401, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6227.65, "standard_charge_percentage": 98.0000, "estimated_amount": 6227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4739.05, "standard_charge_percentage": 78.5000, "estimated_amount": 4739, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5401.54, "standard_charge_percentage": 85.0000, "estimated_amount": 5401, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4589.4, "standard_charge_percentage": 78.5000, "estimated_amount": 4589, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1056, "estimated_amount": 1056, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4766.06, "standard_charge_percentage": 75.0000, "estimated_amount": 4766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3177.38, "standard_charge_percentage": 50.0000, "estimated_amount": 3177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4489.63, "standard_charge_percentage": 78.5000, "estimated_amount": 4489, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3177.38, "standard_charge_percentage": 50.0000, "estimated_amount": 3177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6037.01, "standard_charge_percentage": 95.0000, "estimated_amount": 6037, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4838.82, "standard_charge_percentage": 78.5000, "estimated_amount": 4838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6354.75, "standard_charge_percentage": 100.0000, "estimated_amount": 6354, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3177.38, "standard_charge_percentage": 50.0000, "estimated_amount": 3177, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3495.11, "standard_charge_percentage": 55.0000, "estimated_amount": 3495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4739.05, "standard_charge_percentage": 78.5000, "estimated_amount": 4739, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1906.42, "standard_charge_percentage": 30.0000, "estimated_amount": 1906, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4838.82, "standard_charge_percentage": 78.5000, "estimated_amount": 4838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5560.41, "standard_charge_percentage": 87.5000, "estimated_amount": 5560, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1056, "estimated_amount": 1056, "methodology": "fee schedule" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2541.9, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2541, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4988.48, "standard_charge_percentage": 78.5000, "estimated_amount": 4988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5083.8, "standard_charge_percentage": 80.0000, "estimated_amount": 5083, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2516.48, "standard_charge_percentage": 39.6000, "estimated_amount": 2516, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4838.82, "standard_charge_percentage": 78.5000, "estimated_amount": 4838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4838.82, "standard_charge_percentage": 78.5000, "estimated_amount": 4838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6037.01, "standard_charge_percentage": 95.0000, "estimated_amount": 6037, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 6354.75, "estimated_amount": 6354, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22846", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7034.28,"minimum": 2110.28,"maximum": 7034.28,"payers_information":[{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5356.25, "standard_charge_percentage": 78.5000, "estimated_amount": 5356, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6330.85, "standard_charge_percentage": 90.0000, "estimated_amount": 6330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3517.14, "standard_charge_percentage": 50.0000, "estimated_amount": 3517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5356.25, "standard_charge_percentage": 78.5000, "estimated_amount": 5356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5356.25, "standard_charge_percentage": 78.5000, "estimated_amount": 5356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 6154.99, "standard_charge_percentage": 87.5000, "estimated_amount": 6154, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2785.57, "standard_charge_percentage": 39.6000, "estimated_amount": 2785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5521.91, "standard_charge_percentage": 78.5000, "estimated_amount": 5521, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5356.25, "standard_charge_percentage": 78.5000, "estimated_amount": 5356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3868.85, "standard_charge_percentage": 55.0000, "estimated_amount": 3868, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5245.81, "standard_charge_percentage": 78.5000, "estimated_amount": 5245, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4969.72, "standard_charge_percentage": 78.5000, "estimated_amount": 4969, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5521.91, "standard_charge_percentage": 78.5000, "estimated_amount": 5521, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6893.59, "standard_charge_percentage": 98.0000, "estimated_amount": 6893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2110.28, "standard_charge_percentage": 30.0000, "estimated_amount": 2110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5356.25, "standard_charge_percentage": 78.5000, "estimated_amount": 5356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 7034.28, "standard_charge_percentage": 100.0000, "estimated_amount": 7034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3517.14, "standard_charge_percentage": 50.0000, "estimated_amount": 3517, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5979.14, "standard_charge_percentage": 85.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6330.85, "standard_charge_percentage": 90.0000, "estimated_amount": 6330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5521.91, "standard_charge_percentage": 78.5000, "estimated_amount": 5521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5245.81, "standard_charge_percentage": 78.5000, "estimated_amount": 5245, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 7034.28, "estimated_amount": 7034, "methodology": "fee schedule" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5979.14, "standard_charge_percentage": 85.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3517.14, "standard_charge_percentage": 50.0000, "estimated_amount": 3517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6682.57, "standard_charge_percentage": 95.0000, "estimated_amount": 6682, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 5080.16, "standard_charge_percentage": 78.5000, "estimated_amount": 5080, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6330.85, "standard_charge_percentage": 90.0000, "estimated_amount": 6330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5466.69, "standard_charge_percentage": 78.5000, "estimated_amount": 5466, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2813.71, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5627.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6682.57, "standard_charge_percentage": 95.0000, "estimated_amount": 6682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5275.71, "standard_charge_percentage": 75.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22853", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6810.93,"minimum": 511,"maximum": 6810.93,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3746.01, "standard_charge_percentage": 55.0000, "estimated_amount": 3746, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 5108.2, "standard_charge_percentage": 75.0000, "estimated_amount": 5108, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5959.56, "standard_charge_percentage": 87.5000, "estimated_amount": 5959, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5789.29, "standard_charge_percentage": 85.0000, "estimated_amount": 5789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 6810.93, "standard_charge_percentage": 100.0000, "estimated_amount": 6810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5346.58, "standard_charge_percentage": 78.5000, "estimated_amount": 5346, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 6810.93, "estimated_amount": 6810, "methodology": "fee schedule" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 5186.18, "standard_charge_percentage": 78.5000, "estimated_amount": 5186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 5346.58, "standard_charge_percentage": 78.5000, "estimated_amount": 5346, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4918.85, "standard_charge_percentage": 78.5000, "estimated_amount": 4918, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 3405.47, "standard_charge_percentage": 50.0000, "estimated_amount": 3405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 5186.18, "standard_charge_percentage": 78.5000, "estimated_amount": 5186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3900, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 5079.25, "standard_charge_percentage": 78.5000, "estimated_amount": 5079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 5346.58, "standard_charge_percentage": 78.5000, "estimated_amount": 5346, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 5293.11, "standard_charge_percentage": 78.5000, "estimated_amount": 5293, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 5079.25, "standard_charge_percentage": 78.5000, "estimated_amount": 5079, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 6129.84, "standard_charge_percentage": 90.0000, "estimated_amount": 6129, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 6674.71, "standard_charge_percentage": 98.0000, "estimated_amount": 6674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5789.29, "standard_charge_percentage": 85.0000, "estimated_amount": 5789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 5186.18, "standard_charge_percentage": 78.5000, "estimated_amount": 5186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 6129.84, "standard_charge_percentage": 90.0000, "estimated_amount": 6129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3405.47, "standard_charge_percentage": 50.0000, "estimated_amount": 3405, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 5186.18, "standard_charge_percentage": 78.5000, "estimated_amount": 5186, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 6470.38, "standard_charge_percentage": 95.0000, "estimated_amount": 6470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 6470.38, "standard_charge_percentage": 95.0000, "estimated_amount": 6470, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4811.92, "standard_charge_percentage": 78.5000, "estimated_amount": 4811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 6129.84, "standard_charge_percentage": 90.0000, "estimated_amount": 6129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2043.28, "standard_charge_percentage": 30.0000, "estimated_amount": 2043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 5186.18, "standard_charge_percentage": 78.5000, "estimated_amount": 5186, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2697.13, "standard_charge_percentage": 39.6000, "estimated_amount": 2697, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 5448.74, "standard_charge_percentage": 80.0000, "estimated_amount": 5448, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 3405.47, "standard_charge_percentage": 50.0000, "estimated_amount": 3405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2724.37, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2724, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22854", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5331.84,"minimum": 511,"maximum": 5331.84,"payers_information":[{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4143.64, "standard_charge_percentage": 78.5000, "estimated_amount": 4143, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 5331.84, "estimated_amount": 5331, "methodology": "fee schedule" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2665.92, "standard_charge_percentage": 50.0000, "estimated_amount": 2665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2132.74, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 4665.36, "standard_charge_percentage": 87.5000, "estimated_amount": 4665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2111.41, "standard_charge_percentage": 39.6000, "estimated_amount": 2111, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 2932.51, "standard_charge_percentage": 55.0000, "estimated_amount": 2932, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5065.25, "standard_charge_percentage": 95.0000, "estimated_amount": 5065, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2665.92, "standard_charge_percentage": 50.0000, "estimated_amount": 2665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 5331.84, "standard_charge_percentage": 100.0000, "estimated_amount": 5331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4185.49, "standard_charge_percentage": 78.5000, "estimated_amount": 4185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 3976.22, "standard_charge_percentage": 78.5000, "estimated_amount": 3976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4059.93, "standard_charge_percentage": 78.5000, "estimated_amount": 4059, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 4532.06, "standard_charge_percentage": 85.0000, "estimated_amount": 4532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 3976.22, "standard_charge_percentage": 78.5000, "estimated_amount": 3976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4059.93, "standard_charge_percentage": 78.5000, "estimated_amount": 4059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4185.49, "standard_charge_percentage": 78.5000, "estimated_amount": 4185, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 4798.66, "standard_charge_percentage": 90.0000, "estimated_amount": 4798, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 3850.65, "standard_charge_percentage": 78.5000, "estimated_amount": 3850, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5065.25, "standard_charge_percentage": 95.0000, "estimated_amount": 5065, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3199.1, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4059.93, "standard_charge_percentage": 78.5000, "estimated_amount": 4059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 3766.94, "standard_charge_percentage": 78.5000, "estimated_amount": 3766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 4798.66, "standard_charge_percentage": 90.0000, "estimated_amount": 4798, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5225.2, "standard_charge_percentage": 98.0000, "estimated_amount": 5225, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4185.49, "standard_charge_percentage": 78.5000, "estimated_amount": 4185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2665.92, "standard_charge_percentage": 50.0000, "estimated_amount": 2665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1599.55, "standard_charge_percentage": 30.0000, "estimated_amount": 1599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 4798.66, "standard_charge_percentage": 90.0000, "estimated_amount": 4798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4059.93, "standard_charge_percentage": 78.5000, "estimated_amount": 4059, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 3998.88, "standard_charge_percentage": 75.0000, "estimated_amount": 3998, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4265.47, "standard_charge_percentage": 80.0000, "estimated_amount": 4265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 4532.06, "standard_charge_percentage": 85.0000, "estimated_amount": 4532, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 511, "estimated_amount": 511, "methodology": "case rate" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4059.93, "standard_charge_percentage": 78.5000, "estimated_amount": 4059, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22855", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5892.68,"minimum": 1767.8,"maximum": 5892.68,"payers_information":[{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 5598.05, "standard_charge_percentage": 95.0000, "estimated_amount": 5598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Auto", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Commercial", "standard_charge_dollar": 2357.07, "standard_charge_percentage": 40.0000,"standard_charge_algorithm": "Not To Exceed $4619", "estimated_amount": 2357, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 4419.51, "standard_charge_percentage": 75.0000, "estimated_amount": 4419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Occunet", "plan_name": "Occunet Workers Compensation", "standard_charge_dollar": 4486.98, "standard_charge_percentage": 78.5000, "estimated_amount": 4486, "methodology": "percent of total billed charges" } ,{ "payer_name": "EVERNORTH BEHAVIORAL HEALTH", "plan_name": "EVERNORTH BEHAVIORAL HEALTH COMMERCIAL", "standard_charge_dollar": 2946.34, "standard_charge_percentage": 50.0000, "estimated_amount": 2946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2946.34, "standard_charge_percentage": 50.0000, "estimated_amount": 2946, "methodology": "percent of total billed charges" } ,{ "payer_name": "National Healthcare Solutions, INC", "plan_name": "National Healthcare Solutions Commercial", "standard_charge_dollar": 2946.34, "standard_charge_percentage": 50.0000, "estimated_amount": 2946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Viva Health", "plan_name": "Viva Health Commercial", "standard_charge_dollar": 3535.61, "standard_charge_percentage": 60.0000,"standard_charge_algorithm": "Not To Exceed $3900", "estimated_amount": 3535, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Commercial", "standard_charge_dollar": 5303.41, "standard_charge_percentage": 90.0000, "estimated_amount": 5303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Health Choice Of Alabama (HEALTHNET)", "plan_name": "Health Choice Of Alabama (HEALTHNET) Commercial", "standard_charge_dollar": 3240.97, "standard_charge_percentage": 55.0000, "estimated_amount": 3240, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Workers Compensation", "standard_charge_dollar": 4486.98, "standard_charge_percentage": 78.5000, "estimated_amount": 4486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Compone", "plan_name": "Compone Workers Compensation", "standard_charge_dollar": 4163.18, "standard_charge_percentage": 78.5000, "estimated_amount": 4163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Commercial", "standard_charge_dollar": 5156.1, "standard_charge_percentage": 87.5000, "estimated_amount": 5156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Auto", "standard_charge_dollar": 5598.05, "standard_charge_percentage": 95.0000, "estimated_amount": 5598, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC All Payer", "standard_charge_dollar": 4997, "estimated_amount": 4997, "methodology": "case rate" } ,{ "payer_name": "Star Healthcare", "plan_name": "Star Healthcare Commercial", "standard_charge_dollar": 5008.78, "standard_charge_percentage": 85.0000, "estimated_amount": 5008, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Auto", "standard_charge_dollar": 5008.78, "standard_charge_percentage": 85.0000, "estimated_amount": 5008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Commercial", "standard_charge_dollar": 5303.41, "standard_charge_percentage": 90.0000, "estimated_amount": 5303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Commercial", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Workers Compensation", "standard_charge_dollar": 4625.75, "standard_charge_percentage": 78.5000, "estimated_amount": 4625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis(fka Stratose) Workers Compensation", "standard_charge_dollar": 4394.47, "standard_charge_percentage": 78.5000, "estimated_amount": 4394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Select", "plan_name": "Provider Select Workers Compensation", "standard_charge_dollar": 4579.5, "standard_charge_percentage": 78.5000, "estimated_amount": 4579, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Workers Compensation", "standard_charge_dollar": 4255.69, "standard_charge_percentage": 78.5000, "estimated_amount": 4255, "methodology": "percent of total billed charges" } ,{ "payer_name": "Three Rivers", "plan_name": "Three Rivers Auto", "standard_charge_dollar": 5303.41, "standard_charge_percentage": 90.0000, "estimated_amount": 5303, "methodology": "percent of total billed charges" } ,{ "payer_name": " Corvel", "plan_name": "Corvel Accident & Health", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Auto", "standard_charge_dollar": 5892.68, "standard_charge_percentage": 100.0000, "estimated_amount": 5892, "methodology": "percent of total billed charges" } ,{ "payer_name": "Department Of Industrial Labor", "plan_name": "Department Of Industrial Labor WC", "standard_charge_dollar": 4625.75, "standard_charge_percentage": 78.5000, "estimated_amount": 4625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Provider Network of America", "plan_name": "Provider Network of America Commercial", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Workers Compensation", "standard_charge_dollar": 4486.98, "standard_charge_percentage": 78.5000, "estimated_amount": 4486, "methodology": "percent of total billed charges" } ,{ "payer_name": " Americas Choice Provider Network", "plan_name": "Americas Choice Provider Network Auto", "standard_charge_dollar": 5774.83, "standard_charge_percentage": 98.0000, "estimated_amount": 5774, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS AL Commercial", "standard_charge_dollar": 5892.68, "estimated_amount": 5892, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": "United HealthCare", "plan_name": "UHC Commercial Options PPO", "standard_charge_dollar": 2333.5, "standard_charge_percentage": 39.6000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Workers Compensation", "standard_charge_dollar": 4486.98, "standard_charge_percentage": 78.5000, "estimated_amount": 4486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Auto", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan (dba Claritev) Commercial", "standard_charge_dollar": 4714.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4625.75, "standard_charge_percentage": 78.5000, "estimated_amount": 4625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Novanet", "plan_name": "Novanet Workers Compensation", "standard_charge_dollar": 4394.47, "standard_charge_percentage": 78.5000, "estimated_amount": 4394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Multiplan", "plan_name": "Multiplan Workers Compensation", "standard_charge_dollar": 4486.98, "standard_charge_percentage": 78.5000, "estimated_amount": 4486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1767.8, "standard_charge_percentage": 30.0000, "estimated_amount": 1767, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "22901", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 22743.1, "discounted_cash": 3342,"minimum": 374.23,"maximum": 22743.1,"payers_information":[{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Auto", "standard_charge_dollar": 17057.3, "standard_charge_percentage": 75.0000, "estimated_amount": 17057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Prime Health Services", "plan_name": "Prime Health Services Commercial", "standard_charge_dollar": 21606, "standard_charge_percentage": 95.0000, "estimated_amount": 21605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Simpra Advantage", "plan_name": "Simpra Advantage Medicare", "standard_charge_dollar": 2597.03, "estimated_amount": 2597, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 17853.3, "standard_charge_percentage": 78.5000, "estimated_amount": 17853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 11371.6, "standard_charge_percentage": 50.0000, "estimated_amount": 11371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Zelis(fka Stratose)", "plan_name": "Zelis (fka Stratose) Commercial", "standard_charge_dollar": 18194.5, "standard_charge_percentage": 80.0000, "estimated_amount": 18194, "method